Children and adolescents
JIA-associated uveitis
Usually painless and silent. Detected only by slit-lamp screening, so every child with JIA needs scheduled eye exams.
What to look for
- Often no symptoms. Can cause synechiae, cataract, glaucoma and vision loss.
- Highest risk: oligoarticular or polyarticular RF-negative JIA, ANA-positive, onset before age 7, within 4 years of onset
What to do
- High-risk children need a slit-lamp exam every 3 months (ACR 2019; reaffirmed 2026).
- Active uveitis needs urgent ophthalmology and rheumatology co-management.
- Methotrexate is the preferred first DMARD and adalimumab the preferred biologic.
About this urgency level
Early specialist assessment changes outcomes. Send the usual workup with the referral, but don't hold the referral while waiting for results.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.