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This is how you can treat eye disease that also affects children - Walla! health

2019-12-15T12:46:59.027Z


Ovaitis is a group of inflammatory diseases that involve the inside of the eye. Anterior obesity is the most common type of obesity in children. Appropriate treatments provided on time ...


This is how you can treat eye disease that also affects children

Ovaitis is a group of inflammatory diseases that involve the inside of the eye. Anterior obesity is the most common type of obesity in children. Appropriate timely treatments significantly increase the chance of maintaining good vision. Instructions

Also harms children. Ovaitis (illustration photo: shutterstock)

Baby eye test (Photo: ShutterStock)

Uveitis is a group of inflammatory diseases that involve the grapevine - Uvea - and its surroundings.
The grapefruit is the inside of the eye that consists of the iris, the restrained body and the imagery.

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What types of obesity exist?

You can enumerate several types of obiitis. Each one focuses on a different part of the eye:

Anterior obitis: involves the front of the eye. Arched and / or anterior part of the resting body.

Middle Ovaitis: Involves the vitreous. It is located at the back of the resting body and / or the Parsena palna and / or the most peripheral part of the retina.

Rear Ovaitis: Involves the imaging and / or retina. Originated in imaging and / or retina.

Also, there may be ovaitis that involves all ocular segments - anterior, middle, and posterior.

What Causes Ovaitis?

Ovaitis can be infectious and can be caused by a variety of or non-infectious generators. In this case, it may be related to general diseases of the body that also involve the eye, or it may appear as an eye disease only. Many times, despite extensive inquiries, the cause of the inflammation is not found. In some cases, the detection of ocular disease leads to a general disease diagnosis that was previously unknown.

What are the typical symptoms?

The complaints that accompany the disease are related to the type of ovaitis: in the front ovaitis there may be discomfort, eye pain, and sometimes the projection of the head to the head, difficulty in looking at a light source, red eye and decreased vision. In middle and posterior obesity, on the other hand, there may be decreased vision and visual disturbance, which is manifested by "floating" points or "floating" forms in the visual field. When these complaints appear, it is very important to get a comprehensive eye exam to diagnose the type of disease and get the appropriate treatment quickly.

How is the disease diagnosed?

In order to diagnose the disease, it is important to know the patient's medical background, including information on family illnesses, medication use, exposure to animals, trips in Israel and around the world, and more.

The diagnosis is made through a thorough eye examination in a slit lamp. This test allows to see if the disease involves one or two eyes and define its type. As needed, additional eye exams are performed: eye photographs, imaging of other organs in the body such as the chest, pelvis and head, as well as blood tests. It is important to emphasize that these tests are optimally tailored to each case.

What is important to know about childhood obesity?

Five to ten percent of all obesity patients are children under 18. The childhood obesity-related illnesses are similar to those in adults, and the most common disease in children is Juvenile Idiopathic Arthritis (JIA). This is a joint disease that mainly involves the knees, ankles, wrists and small joints in the arms and legs. As for the eyes, these are anterior obesity that is often present without prominent findings, (such as red eye). Therefore, many times the children do not report any complaints.

The proportion of children who may experience vision impairment is about one-third of JIA patients. Therefore, it is very important for children with JIA to be tested for routine eye exams, as, as mentioned, they often do not experience a change in vision and do not complain of pain, and thus can diagnose their illness when it is in its advanced stages.

What are the ways of treatment?

Ophthalmic treatment in children requires close collaboration and follow-up between experts from two areas of medicine - Ophthalmology and Rheumatology: Ophthalmologists, Ophthalmologists in Pediatrics and Pediatric Rheumatology.

Anterior obesity treatment includes eye drops and sometimes steroid-containing ointments, depending on the severity of the inflammation. In addition, drops that extend the pupil and relax the callous body muscles are relieved, which relieves pain and prevents complication of the iris tightening of the eye lens.

The treatment of middle and posterior ovaries is different, as in these situations the topical treatment with drops is ineffective and better penetrating eye care is needed. The options are to inject steroids around the eye or into the vitreous or to administer steroids orally and in severe cases even intravenously. The mainstay of anti-inflammatory therapy is still the steroid treatment. It is an effective treatment but may involve side effects, whether due to high dose use or prolonged use.

The diagnosis is made through a thorough eye examination (illustration photo (photo: shutterstock)

Illustration (Photo: ShutterStock)

Side effects that may appear in oral care include: rising sugar values, changes in body salts, bone thinning and fracture appearance, obesity, mood changes, sleep disorders as well as growth disturbance, which are essential in children. The higher the steroid dosage and the duration of treatment, the greater the chance of side effects. In cases where steroid therapy is not a solution, or when it is accompanied by side effects, another anti-inflammatory therapy should be added, with a gradual reduction of steroid therapy.

Childhood arthritis is a chronic disease that involves the front of the eye and therefore prolonged treatment is needed. This disease has no place for oral steroid therapy nor long-term treatment with high-dose steroidal drops as regular therapy.

Therefore, non-steroidal anti-inflammatory replacement therapy is required. The common treatment that has existed for many years is "methotrexate" - an anti-inflammatory drug from the antimetabolite group. Treatment is given orally or subcutaneously once a week. The starting effect of the treatment is between 8-6 weeks, during which time steroid drops should be continued. In most cases the drug is effective but in situations where it is ineffective or when side effects appear, another treatment is needed.

In recent years, the use of biological drugs (specific antibodies against proteins involved in the inflammatory process) began. Tumor necrosis factor-alpha (TNF-a) is a protein of great importance in the formation of the intraocular inflammatory process and its neutralization may result in suppression of the inflammatory process.

Which studies support innovative biological therapy?

Reports on the use of biomira in children with ovaitis were first published in 2006. The Sycamore study, published in 7201 in the prestigious New England Journal of Medicine, examined the efficacy and safety of using biomira in combination with methotrexate in children with anterior aneurysm secondary to childhood arthritis. The study showed that the addition of biomira resulted in better results, and in a high percentage of patients the intraocular inflammatory process was controlled, and the treatment also enabled the reduction of steroid drops and even discontinuation in many patients.

Is this treatment backed by formal approvals?

EMAIR is approved in the drug basket for the treatment of children over two years of age with non-infectious ovais (all types of ovaitis) and among adults over 18 with non-infectious ovaitis involving the posterior segment of the eye.

Does the treatment involve side effects?

The treatment of biomira usually does not cause side effects but increases the chance of infectious diseases. Also, live vaccines should be avoided during treatment.

In cases where pretreatment is ineffective, other biological treatment should be switched. There are a variety of other biological therapies: Infliximb (Remicade), also an antidote for TNF-a administered intravenously in a hospital setting; Tosilizumab (Actamara), an antibody to IL6, is administered subcutaneously or intravenously and Ritoximb (Mabatra) antibody to CD20 is administered into the vein.

What are the general recommendations for parents?

According to the Ministry of Health's recommendations, eye examinations for children should be performed routinely at the age of six months, again at the age of three and again before entering the first grade. In addition, an eye exam is recommended when the child reports one of the following symptoms: loss of vision, difficulty in looking at a light source, seeing floating bodies in the field of vision, eye pain or eye discomfort when the complaints do not go away. In situations where the parents notice the child's difficulty in seeing close or distant, and when his or her eye appears to be red or when the pupil's appearance does not look normal.

In the event that ovarian disease is diagnosed, it is of great importance to persevere in the recommended treatment as well as regular follow-up, in order to ensure that the treatment is effective and no other treatment is required.

These days, the "See" nonprofit organization is establishing the Ubaitis patient community. We invite patients and their families to enroll in a community aimed at exchanging opinions, requesting information, medical recommendations and receiving information on patients' rights, and even being a support group for patients of all ages and their families.

To the community

To see the association see

In summary, Uveitis is a group of inflammatory eye diseases that can also appear in childhood. Proper and fast diagnosis is very important in order to adapt the best treatment. Today, there are advanced therapies, including biological treatments, which often produce good results.

Dr. Zohar Chabot-Wilner is the director of the Ovaitis Service, the director of the combined eye inflammatory and joint disease clinic and a senior physician in the retina unit at Tel Aviv Medical Center. Chair of the Ovaitis Circle of the Israeli Ophthalmology Association.

Helped prepare the article: Michal Halperin, zap doctors reporter.

Source: walla

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