Medical Minute 7-21: Stealing a Child's Sight

By: Vanessa Welch Email
By: Vanessa Welch Email

At three years old, Julia Fong was diagnosed with pediatric uveitis and her parents had no idea she had it.

"Because you don't see any outward symptoms, you assume everything is ok and that may not be the case," said Eileen Fong, Julia's mother.

When Julia was about two, her parents got hit with the news that she juvenile idiopathic arthritis. In some cases, the inflammation experienced can affect the child's eyes. A year later, they found out that their youngest daughter could lose her sight forever.

"Conceivably she could go blind, that fear is a parents greatest nightmare," said Milton Fong, Julia's Father.

Dr. David Chu is a pediatric uveitis expert at UMDNJ in Newark, New Jersey. His specialty is rare and so are his patients. There are just over two-thousand new cases in the U.S. each year.

"It is not a common disease, but the consequences can be severe," said David Chu, M.D., Uveitis specialist Associate Professor of Ophthalmology at New Jersey Medical School.

The key is treatment and fast.

"We need to make sure the inflammation does not act up and damage the eye beyond repair."

Julia is on intravenous anti-body drugs. Other treatments for the disease can include steroids, even chemotherapy. They help control the immune system and keep inflammation down.

The hope that that with continued treatment, Julia will be cured and will be able to see everything life has to offer.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500, jcherry@ivanhoe.com.

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BACKGROUND: It's a rare disease that targets toddlers and can steal their sight forever. "Pediatric Uveitis is not a common disease but the consequences can be severe," stated Dr. David Chu, Uveitis specialist and Associate Professor of Ophthalmology at New Jersey Medical School. Uveitis is the third leading cause of blindness in America and five to ten percent of cases occur in children under the age of 16. There are approximately 115,000 cases of pediatric uveitis in the United States with 2,250 new cases occurring each year. For child diagnosed with pediatric uveitis and their family the stakes are incredibly high for they will be faced with many years of dealing with this problem. (Source: Dr. David Chu)

WHAT IS UVEITIS?: Uveitis occurs when the inside of the eye, specifically the three parts that make up the uvea-the iris, ciliary body and choroid- become inflamed. If left untreated this can lead to scarring, cataracts, glaucoma, and blindness, so immediate care is very important. Diseases of muscles and joints can affect the eyes. Juvenile arthritis, an auto-immune disease that affects one out of every 500 children, is the leading cause of uveitis in children. (Source: Uveitis.org)

ACTING TOGETHER: It is critical that the general ignorance about the severity of pediatric uveitis be eliminated by avoiding the all-too-common pronouncement by physicians that: "They will grow out of it," "The drops will get them through it," or "It's just the eye; systematic therapy is not warranted." The issues with these statements, although they are generally true, are that they encourage the parents to use endless amounts of topical steroid therapy. (Source: Uveitis.org)

DAMAGE IS DONE: Generally by the time a child grows out of pediatric uveitis, permanent structural damage is already done to the retina, optic nerve, or aqueous outflow pathways, making the blinding consequences permanent. Although steroid drops usually will help the patient get through this, many children have recurrent episodes of uveitis. The steroid therapy used for each episode will eventually produce vision-robbing damage.

HOW TO TREAT IT: Treatments for uveitis include steroid drops for the eye, medical infusions used to treat a variety of diseases such as arthritis, and medication. These help children maintain their vision while inflammation in and around the eye goes down. The most important treatment however, is an early diagnosis to begin tackling this issue right away.

For More Information, Contact:

Dr. David Chu
Associate Professor of Ophthalmology at New Jersey Medical School
973-972-2065
chuda@umdnj.edu


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