The American Academy of Pediatrics provides guidelines on screening for uveitis in children who have juvenile arthritis. Those who test positive for antinuclear antibodies are considered more vulnerable. But all children with pauciarticular, polyarticular or systemic arthritis should be regularly checked.
To simplify the complex screening guidelines, physicians at the University of Minnesota assessed the levels of risk:
Higher risk: Any child with the oligoarticular (pauciarticular) or polyarticular form of arthritis who tests positive for antinuclear antibody (ANA) and is younger than age 7 when the disease develops.
Recommendation: Should have a slit-lamp eye exam every three months for the first four years. The test allows your child's doctor to check the surface of the eye (cornea) for dryness-related damage. He’ll administer a dye to stain the tear film, most likely via eye drops, and he may dilate the eyes as well. Then he’ll view it through the slit lamp – a microscope with a high-intensity light source. Your child should be checked every six months for the next three years after the initial test, and annually after that.
Middle risk: Any child with oligoarticular (pauciarticular) or polyarticular arthritis who tests negative for ANA and is younger than age 7 when the disease develops. Or, a child who tests positive for ANA, but is 7 years or older at disease onset.
Recommendation: Should have a slit-lamp exam every six months for the first four years, followed by annual screenings.
Lower risk: Any child with oligoarticular (pauciarticular) or polyarticular arthritis who tests negative for ANA and is 7 years or older when the autoimmune disease is diagnosed. Or, any patients with systemic arthritis.
Recommendation: Should have a slit-lamp eye examination annually.
If your child has another form of arthritis not covered in the AAP guidelines, be sure to check with his rheumatologist for recommendations.