The inborn nasolacrimal duct obstruction is common ocular disease in new-borns and infants. There are still doubts concerning the timing of the operating procedure. Probing of the lacrimal ducts is the therapeutic method for this condition.To evaluate the therapy outcome in congenital nasolacrimal duct obstruction in authors' own material.In retrospective study of 3950 medical records of children from our Outpatient's Clinic, we distinguished 192 children with nasolacrimal duct obstruction. Then, we evaluated the outcome of implemented treatment in correlation with their age and timing of the nasolacrimal duct probing.All children with nasolacrimal duct obstruction had mucopurulent discharge in the lacrimal sac and lacrimation. After the conventional treatment, the disease resolved in 23% of our group, whereas, in the rest of the patients probing of the nasolacrimal duct was implemented. The probing was successful in all children, but it was necessary to repeat the procedure twice in 13 children and three times in 5 children. The success rate of single probing was as follows: 91% in the group of children 1 - 3 months old, 83% in both groups: 3 - 6 and 6 - 12 months old and 71% in the oldest group of children - above 1 year of age.In majority of children the nasolacrimal duct obstruction did not resolve spontaneously. Early probing within first few months of child's life increased the success rate of this procedure.
To analyse the frequency of uveitis and other ocular changes in children with juvenile idiopathic arthritis.We carried out ophthalmologic examination in children and adolescents with juvenile idiopathic arthritis, in age between 3 and 20 years. During the examination we evaluated vision acuity, refraction, anterior and posterior part of the eye and intraocular pressure.A total of 48 (68%) girls and 22 (32%) boys participated in our study, whose mean age was 13.2 years (SD = 3.8). The most frequent onset of juvenile idiopathic arthritis was oligoarticular form of the disease (62%). Only in 42% of the studied group there were no significant abnormalities of the ocular system. Anterior uveitis was diagnosed in 5 patients (7%) including 4 (5.7%) girls and 1 (1.4%) boy. Complications appeared in 2 children in the form of cataract and band keratopathy which both resulted in considerable impairment of visual acuity. Mean duration of juvenile idiopathic arthritis before the onset of uveitis was 5.2 years. There were other ocular changes in the studied group, among which the most common were: conjunctivitis--24%, abnormalities of the retina--11%, glaucoma--4% and other changes.In majority of the children with juvenile chronic arthritis different abnormalities of the eyes were diagnosed. All the patients with juvenile idiopathic arthritis should be under close surveillance of the ophthalmologist, irrespective of the disease duration.
PURPOSE Among numerous complications pertaining to the internal organs in the course of inflammatory systemic diseases of the connective tissue, including juvenile idiopathic arthritis (JIA), eye lesions are of considerable significance. The aim of the study was to determine changes in the eyes in JIA children and adolescents. MATERIAL AND METHODS The study included 76 children with JIA. The age of patients during the first ophthalmologic examination ranged from 3 to 18 years. The children were treated in the Outpatients' Rheumatologic Department at the University Hospital No. 4 in Lodz and Department of Pediatric Ophthalmology at the Medical University of Lodz. A control group consisted of 60 healthy children. In this study the time of observation was 18 months during which the children and adolescents were subjected to complex ophthalmologic examinations in the intervals of 9 months. RESULTS The presence of various ocular changes were significantly more frequently found in children with JIA. The difference appeared to be statistically significant between the group of children with JIA and the control group, in the range of such diseases as conjunctivitis and pigment changes in the retina. CONCLUSIONS In JIA patients ophthalmologic lesions are more frequent than in healthy children, especially it concerns conjunctivitis (in 34% of children) and pigment changes in the retina (in 14% of children).
The aim of the study was to evaluate the dry eye syndrome in children with juvenile idiopathic arthritis (JIA), and its relation to the immunological markers of the JIA (antynuclear antybodies ANA and rheumatoid factor RF).The study included 62 children with JIA. The age of patients during the first ophthalmic examination ranged from 9 to 18 years (62 children). A control group consisted of 49 healthy children. The time of observation was 18 months during which the children and adolescents were subjected to complex ophthalmic examinations (including a history of eye discomfort and Schirmer and BUT tests), in the intervals of 9 months. The diagnosis towards dry eye syndrome was made (including a history of eye discomfort and Schirmer and BUT tests).The majority of children with JIA complained of discomfort in the eyes. The difference appeared to be statistically significant between the group of children with JIA and the control group in the range of 5 features. The results of Schirmer test were found to be inadequate in 7 children (13%) and of BUT test in 9 children (15%). In total, inadequate results of Schirmer and/or BUT tests and a high score of discomfort evaluation were detected in 11 patients (17.7%).1. The dry eye syndrome may occur in the course of JIA in children without any distinct clinical signs, resulting in subjective symptoms and decreasing the quality of life. 2. No correlation between immunological markers of the JIA and ocular changes was observed.
Objectives Uveitis and juvenile idiopathic arthritis (JIA) relatively often coexist. Inflammatory changes in the anterior segment of the eye are the most common extra-articular symptom in children with JIA, and JIA is, in turn, the main systemic cause of anterior uveitis in children. The aim of our study was to compare the course of anterior uveitis accompanying JIA and isolated uveitis. Material and methods We analyzed 25 children with JIA and uveitis (group I) and 28 children with isolated uveitis (group II). The study population was retrospectively selected from the patients treated in our center in the years 1998–2016 through a search of the hospital database. All data were presented as descriptive statistics. Results In group I there was a higher percentage of girls than in group II (64% vs. 50%) and uveitis occurred at a significantly younger age (8.7 years vs. 11.6). Patients from group I more often presented with immunological abnormalities (positive antinuclear antibodies or HLA-B27 antigen). The majority of children from group I developed uveitis prior to (44%) or simultaneously with (20%) arthritis. In patients who first presented with uveitis, arthritis appeared on average after 28 months (median 12 months). In children in whom arthritis developed first, uveitis appeared on average after 51 months (median 36 months). In some patients the time interval between the involvement of these two organs was as long as 9–10 years. Four children from group I and three from group II were qualified for biological treatment. Conclusions The results of our analysis indicate the need for constant cooperation between the pediatric rheumatologist and the ophthalmologist. Although the risk of uveitis in JIA decreases with the disease duration, in some cases this complication can develop after many years. Children with present antinuclear antibodies, at younger age and of female gender should be subject to particularly close observation.
