About Pediatric Uveitis Surgery

Pediatric uveitis surgery relieves symptoms and lessens complications from uveitis, a chronic eye condition which can decrease vision. Uveitis is caused by inflammation in the middle layer of the eye (the uvea), which can cause cataracts, glaucoma and retinal damage. The condition can lead to permanent eye changes, including vision loss and sometimes blindness.

Uveitis can be linked to an underlying autoimmune disease, such as juvenile idiopathic arthritis. Even when there is no underlying cause, uveitis is often treated with medications that suppress the abnormal response of the immune system. Therefore, diagnosis and treatment often require evaluation by an ophthalmologist (eye specialist) and a rheumatologist (inflammation and immunosuppressive medication specialist). In some cases, surgery is needed to deal with the consequences of inflammation in the eye.

How can surgery for uveitis help my child?

Your child’s ophthalmologist will recommend the pediatric uveitis treatment based on their unique condition and symptoms. For mild cases, your child’s doctor may recommend eye drops that lessen inflammation and help control pain. Children with more severe uveitis may need oral medications, injections or infusions to reduce inflammation.

Chronic inflammation inside the eye can cause cataracts, glaucoma and damage to the retina. At Children’s Hospital Colorado, we have a multidisciplinary team of pediatric eye surgeons, including pediatric glaucoma and pediatric retina surgeons, who can perform these procedures for children with severe uveitis. To improve your child’s vision and/or address complications caused by uveitis, your child’s ophthalmologist may recommend personalized surgery that may include:

• Cataract surgery: to remove a cloudy lens, with or without placement of an artificial lens
• Glaucoma surgery: to better control a high eye pressure and reduce damage to the optic nerve
• Implantation of a long-lasting medication to help control inflammation (i.e. steroid implants such as Yutiq)
• Cryotherapy: to freeze inflamed areas of retina and prevent them from causing additional problems
• Retinal surgery: such as a vitrectomy, in which the doctor removes the vitreous, a gel-like substance that fills the eyeball

Does my child need uveitis cataract surgery?

Some children with uveitis may also develop cataracts but not all children with cataracts need surgery immediately. Timing of surgery depends on their vision, associated eye complications and the age of the patient. Cataract surgery in patients with uveitis removes the cloudy lens in the eye and when the natural lens is removed, the eye can no longer focus on light to create clear images. Your ophthalmologist will recommend one or more of the following to replace the natural lens:

• Intraocular lens implant (an implant of an artificial lens)
• Contact lenses
• Glasses

What to expect during uveitis surgery

Your child’s ophthalmologist will recommend surgery only when it is necessary to protect vision and to control uveitis. Your child may need additional medications to decrease inflammation before and after the surgery, as surgery inside the eye can temporarily increase inflammation.

During intraocular surgery, your child’s team will:

1. Put drops in their eye to dilate (widen) the pupil (the dark black circle in the center of the eye)
2. Give your child general anesthesia to put them to sleep
3. Make a small incision in the eye and then use small tools to remove the cloudy lens (cataract surgery), open up a new passageway for fluid to flow (glaucoma surgery) or to remove the vitreous (vitrectomy)
4. Make other necessary repairs, such as treating abnormal blood vessels using lasers or opening up a pupil which has been stuck down
5. Close the eye with sutures and apply antibiotics and anti-inflammatory medicines

What to expect after surgery for uveitis

After uveitis surgery, your child will be moved to a recovery room until they can go home, which is usually the same day.

Your child’s uveitis specialist will give you specific instructions for recovery. Your child may need certain positioning after surgery. They may have to wear a patch to protect the eye or take certain medications (usually eyedrops). Your child may need time off school for post-op visits and have limitations in certain activities such as no swimming for 2 weeks after surgery.

The eye may feel puffy, sore or irritated, and the surrounding area may be red or bruised. Your child’s vision may be blurry and sensitive to light after the procedure. All these symptoms get better with time, and your child will have follow-up appointments with their ophthalmologist to monitor their eye and vision over time.

If your child had a diagnostic vitrectomy, your ophthalmologist may send some of the vitreous to a lab for examination. Lab tests can identify bacterial, fungal or genetic causes of uveitis.

Why choose us for pediatric uveitis treatment?

The Children’s Hospital Colorado Department of Pediatric Ophthalmology treats the entire child — not just their eye symptoms. We offer:

• Experience and expertise: Our uveitis specialists have extensive experience managing even the most complicated cases. We provide medical and surgical treatment options in a state-of-the-art facility.
• Uveitis Clinic: Designated clinic times are available for patients to see our uveitis specialists. 
• Ophthalmology-Rheumatology Clinic: This unique program combines ophthalmology and rheumatology for children who have uveitis due to an underlying autoimmune condition. Your family can see both specialists together in the eye clinic to eliminate multiples appointments and streamline decision-making. Combined visits also lead to more comprehensive care and reduce your travel and time away from work and school.

Contact us

Learn more about the Pediatric Uveitis Clinic at Children’s Hospital Colorado or call 720-777-2020.