Glaucoma: Common, Difficult-to-manage Complication Of Juvenile Rheumatoid   Arthritis

11/02/2000 10:46:50 AM

By Mark Greener

Glaucoma is a common complication of iridocyclitis associated with juvenile   rheumatoid arthritis and often proves difficult to manage, report   researchers from Harvard Medical School, Boston, Massachusetts, USA.

The authors reviewed the records of 69 patients with juvenile rheumatoid   arthritis who developed iridocyclitis. Twenty-nine children showed either   secondary glaucoma or ocular hypertension in a total of 41 eyes. Topical   treatment controlled intraocular pressure in seven of the 41 eyes. Systemic   carbonic anhydrase inhibitors controlled intraocular pressure in another   eight eyes. However, surgery controlled pressure in all the remaining eyes,   with one exception.

The authors concluded that glaucoma is a common complication of   iridocyclitis associated with juvenile rheumatoid arthritis. They suggest   that prolonged, inadequately treated intraocular inflammation causes many   cases of glaucoma and intraocular pressure in this population. Glaucoma   secondary to steroids accounts for a smaller proportion.

The authors note that medical and surgical therapy for glaucoma associated   with uveitis in juvenile rheumatoid arthritis patients is challenging and   not completely effective. The authors suggest that more aggressive treatment   of the uveitis associated with juvenile rheumatoid arthritis, earlier in the   disease's natural history, may reduce glaucoma's impact.

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