Ophthalmic Complications in Pediatric Uveitis.

Purpose: We aim to look at the complications encountered by a cohort of pediatric uveitis patients from north India.Methods: Retrospectively, complications seen in patients younger than 16 years diagnosed with uveitis between January 2006 to March 2015 were noted.Results: Data of 104 children, with a mean follow-up of 3.40 ± 2.34 years was studied. Cataract (n = 42, 24.00%), band-shaped keratopathy (n = 32, 18.29%) and Glaucoma/OHT (n = 11, 6.29%) were most encountered complications at presentation. Glaucoma/OHT (29.71%; n = 52), cataract (18.86%; n = 33) and maculopathy (n=12;6.86%) were the most common complications at follow up. Maculopathy (35%) and Glaucoma/OHT (20%) were the most common causes of visual acuity ≤3/60.Conclusions: Cataract is the most critical complication in children with uveitis at presentation and raised intraocular pressure occurs at follow-up, perhaps attributed to the treatment. Maculopathy is the most common cause of blindness in these children.

Glaucoma Secondary to Uveitis in Children in a Tertiary Care Referral Center.

Purpose: To study outcome of secondary glaucoma in pediatric uveitis patients. Methods: Retrospective analysis of records of uveitis patients ≤16 years. Results: Of 182 pediatric uveitis patients, secondary glaucoma was seen in 48 patients (75 eyes, 26.23%) with female preponderance (F:M-29:19) . JIA was the most common etiology (35.71%). BCVA of ≥20/40 was seen in 22 eyes at presentation and in 38 eyes at final follow up (p<0.001). Twenty eight children (66.67%) received systemic antiglaucoma therapy while 17 children (21 eyes) required surgery (60.71%). Logistic regression showed pseudophakia could predict the higher use of oral antiglaucoma medication (p=0.03) while anatomical site of involvement was predictive of higher chances of surgery (p=0.003). Overall success was seen in 82.10% and 71.64% using IOP limit of 21 and 18 mmHg respectively at mean follow-up of 3.9 years. Conclusion: Pediatric uveitic glaucoma though require multitude of therapies, can be managed effectively with appropriate therapy.

Clinico-radiological features and treatment outcomes in children with traumatic orbital subperiosteal hematoma.

PURPOSE: To study the clinical findings, imaging features, and treatment outcomes in children diagnosed with traumatic orbital subperiosteal hematoma (OSpH). METHODS: The medical records of eligible OSpH children treated either via needle aspiration or open surgical drainage were reviewed retrospectively. Three anatomical factors (inferior globe displacement, superior orbital sulcus fullness, extraocular movements) and two functional parameters (visual acuity, pupillary reactions) were used to determine overall success. RESULTS: A total of 10 children (mean age, 6.8 years; 8 males) were included. All had a history of blunt trauma, unilateral presentation, inferior globe displacement, fullness of superior orbital sulcus, and raised retrobulbar resistance. Diminution of vision and restricted elevation was noted in 7 children, and 4 had a relative afferent pupillary defect. Computed tomography (CT) revealed superior OSpH in all 10 children and, additionally, orbital wall fracture in 4. Needle aspiration of the OSpH was performed in 8 children; 2 underwent open surgical drainage. At a mean follow-up of 8.5 months, all children showed satisfactory improvement in both anatomical and functional parameters:1 child had a persistent nebulomacular corneal opacity, and 1 had minimal upper eyelid edema. CONCLUSIONS: A high index of suspicion, appropriate radiology (CT of orbits), and early management through needle aspiration of OSpH may help in early and satisfactory anatomical and functional outcomes.