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Home | News | Links | How to Help | Contact Us | Search Uveitis: A Guide for Teachers and Parents
INDEX
GETTING STARTED
WHAT IS UVEITIS?
 Anatomy
Uvea (u've'a) is the Latin word for grape. If you could see the uveal tract, it might remind you of a grape that has had its outer skin peeled away. The uvea is brown and round, with a "stem" formed by the optic nerve. "Itis" is the Latin suffix for inflammation. Put the two words together: uve + itis = "uveitis". The uvea surrounds the eye like a tunic (coat). The visible part of the uvea is the iris.
The
uveal tract has three main parts. The iris gives the eye its
characteristic color. It changes shape to control the amount of light
entering the eye. The ciliary body makes fluid for the inside of
the eye. The choroid is very vascular and provides the blood
supply for the eye. Inflammation affecting any of these parts of the eye
is called uveitis.
Teachers and Parents:
Pediatric Uveitis
Uveitis is the third leading cause of preventable blindness in the
developed world. Despite this, it is a rare disease.
Uveitis can develop at any age. It is found in all races and occurs worldwide. It is not
contagious.
Patients with uveitis starting before the age of 16 years represent 5%
to 10% of the all cases of uveitis.
Uveitis has an estimated prevalence of about 38 cases per 100,000
population, and an incidence of 15 cases per 100,000 population.
2,359,242 people in the world are estimated to have the disorder.
In the United States it is estimated that uveitis afflicts 109,000
people and that 43,000 new cases are diagnosed each year. It is estimated that, at any one time, about 11,500
children in the United States will have uveitis and that 2,250 new cases are identified every
year. Uveitis symptoms include pain or redness in the
eye, sensitivity to light (photophobia), blurred or diminished vision, problems with
"glare", seeing black spots (called "floaters"), and
sometimes, abnormal eye movement or alignment. Children with
uveitis are at increased risk for developing glaucoma and cataract. Some children
with
uveitis will become blind. Most children with uveitis will require years of medical
treatment in an effort to save their vision. Roughly half of the children with uveitis will not
have symptoms to warn them of disease activity. In this instance,
the uveitis is usually discovered after there has been irreversible
vision loss caused by damage to the retina or optic nerve.
Vision may fluctuate from relatively "normal" to very poor. Children
with uveitis may be able to read with little assistance one month and
then may need adaptive text the next. Or, the visual problems may be
relatively stable and predictable. Glare can be a big problem inside and
out of doors. Communication with the child's family is crucial to
understanding how your particular student is doing and what specific
adaptations will need to be implemented.
Children with uveitis whose vision impairment interferes with their
ability to do school work qualify for special education considerations
under the Individuals with Disabilities Education Act (IDEA).
(Website:
www.ed.gov/offices/OSERS/Policy/IDEA/regs.html).
Special education considerations in the United States include such
things as support for modification of assignments or the environment, or
for specialized equipment. If the child needs a special computer
screen or program, or a scribe, this could be funded under special
education.
Children with uveitis whose vision does not interfere with school
work may be eligible for accommodations under section 504 of the
American with Disabilities Act (Website:
www.hhs.gov/ocr/504.html).
Please go to the Guidelines Supplement for
links to international Special Education resources.
Because the damage caused by uveitis is inside the
eye, your student may show few outward signs of the disease. Eye
inflammation may not be noticeable except to a trained physician aided
by special medical equipment, but its effects on your student are
noticeable. It is very
important to understand that the symptoms and the limitations of your
student are quite real,
even though the disease may not be obvious to you. Your student with uveitis may not complain, so
please be alert for clues that he or she is having difficulty.
These might include symptoms such as
squinting, avoiding lights, or struggling to see written material. Your
only clue may be observing difficulty completing certain
visually
demanding tasks. Children with uveitis may try to ignore or hide changes
in their vision or other symptoms because they want to be like their
classmates. Uveitis can be caused by infection, an injury to
the eye, or by an autoimmune illness. Uveitis is not contagious.
Uveitis can exist alone, or sometimes it is a sign of other illness. For
example, about 10% of children with Juvenile Idiopathic (Rheumatoid)
Arthritis will develop eye inflammation (uveitis). Doctors will
try to figure out what is causing the child's uveitis. To do this they
will take a careful medical history, order laboratory tests and other studies that help rule out other
conditions. Sometimes the exact cause of the child's uveitis cannot be
determined. Most children who have uveitis have autoimmune uveitis. Click and read: Teachers, Parents, Students:
Uveitis
Glossary Having an autoimmune disorder means that the body
mistakenly identifies some of its own cells and tissues as foreign.
More familiar examples of autoimmune illness are arthritis and diabetes. The
immune system, which normally helps to fight off harmful, foreign
substances such as bacteria or viruses, begins to attack healthy cells
and tissues. The result is inflammation--marked by redness, heat, pain,
and swelling. Doctors do not know why the immune system goes awry in
children who develop uveitis. Scientists suspect that at least several
steps may be involved: First, something in a child's genetic makeup
gives them a tendency to develop uveitis; then contact with some
"trigger" provokes the onset of the problem. Click and read: Teachers and Parents:
Ocular Autoimmune Disease: An Introduction Doctors diagnose uveitis when they see children
with inflammation cells inside the eye during the eye examination. An
ophthalmologist (eye MD) can see the Uveitis cannot be diagnosed in the pediatrician's
office. The general ophthalmologist or pediatric
ophthalmologist will know how to diagnose uveitis. A child who is
thought to have uveitis should be referred to a
specialist for further assessment and treatment. Classroom
exercise: The special expertise of ophthalmologists with
advanced training
in Uveitis and Ocular Immunology is extremely valuable in the care of
children with uveitis. These physicians are cross-trained in immunology
and ophthalmology and are best equipped to deal with the complex
problems of children with uveitis. However, there are very few such specialists,
and most areas of the country have none at all. Children
and their families will usually have to travel a great distance just to
consult with a specialist. In such circumstances, a team approach involving
the child's ophthalmologist and a rheumatologist or chemotherapist with
experience in pediatric rheumatic disease or immunology provides optimal
care for children with uveitis. This local team works with the
consulting specialist who oversees treatment. The child will have to
travel 3-4 times a year to be examined by the specialist, and more
frequently if the disease becomes active during treatment or if vision
decreases. If you know a student with uveitis who needs help
finding specialist resources for treatment, please give the parents our
contact information. We will help them locate
specialist resources. The main goals of treatment are to preserve a high
level of vision and social functioning, and to maintain a good quality
of life. To achieve these goals, doctors recommend treatments to reduce
swelling inside the eye and to put the disease into remission. Parents
are encouraged to enroll themselves and their children in our free
support programs, or if they live a distance, to get involved with our
web-based support community. A student with uveitis will have frequent
doctor's appointments and will have to take medication. Some
children will require eye surgery. Some children will require
special eye glasses or contact lenses to aid their vision. Several years of treatment are required to put the
illness into remission. All children with uveitis will need to
take medication. Most children with uveitis have to take medications
that suppress inflammation and modify how the immune system works. These
medications may be in eye drops, given in a shot, taken by mouth (pills)
or some combinations of these treatments. Sometimes the treatment will
involve eye surgery. Children with chronic or severe forms of uveitis
will require immunosuppressive chemotherapy to protect their vision.
Children requiring chemotherapy will have days when they feel sick or
have less energy or focus. At school,
children with uveitis may need help taking scheduled medications. For
example, they may need to visit the school nurse several times a day to
take special eye drops or other medications.
Medical Appointments: Trips for evaluation and treatment are not fun days away from school.
There are often trips to unfamiliar places or doctors, and a lot of
"scary" (unfamiliar) equipment may be used to examine children. A child
may need to get a shot of medicine, sometimes even into their eye, or
have their blood tested frequently. Special tests may need to be
ordered. Urgent care may be required, causing disruption in school
schedules and family routines. Scientists are investigating the possible causes
of uveitis. Research focuses on trying to improve existing
treatments and on finding new medicines that will work better with fewer side
effects. Click and read:
Research
at the Ocular Immunology and Uveitis Foundation
I agree with what you said about friends not getting it. Right now my two closest friends are both very smart people so they are able to understand what I'm explaining to them, and to empathize. Friends I've had in the past just didn't really comprehend and would sometimes ask "So are your eyes all better now?" Others would never ask me how my eyes were, as if I didn't even have a problem. I don't know which one bothers me more. Probably the ones who didn't ask me anything at all. ~Em Classroom Exercise:
ADAPTING THE EDUCATIONAL SETTING
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A Big Look at the Eye |
| Anatomy of the eye | |
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How Dogs See |
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How The Eye Works |
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The Nocturnal Eye |
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Taking a Good Look at Glasses |
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What is 20/20 Vision? |
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What Visual Impairment is |
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Why do People Have Red Eyes in Some Flash Photography? |
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Taking a Good Look at Glasses |
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How to Take Care of Your Glasses |
| What is uveitis? | |
| What is a cataract? | |
| Why does the doctor check my eye pressure? | |
| What is a slit lamp? | |
| How do blood cells fight disease? | |
The Kids Club is open to any
student or
 class
that would like to participate.
Pre-registration is required to
make use of the Club's safety features. |
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Please go to the Guidelines Supplement for links to international Special Education resources.
Negotiating the Special Education Maze: A Guide for Parents and Teachers. Anderson, W. , Citwood, S., & Hayden, D. (1997). Negotiating the Special Education Maze: A Guide for Parents and Teachers (3rd ed.). Bethesda, MD.: Woodbine House. (800) 843-7323
Children with Low Vision
http://www.low-vision.org
This website gives practical suggestions, appropriate for parents and teachers, for supporting the development of the child with vision challenges. It has material written in English and in Spanish about developing your child's vision, and a guide for parents of infants and young children with vision impairment. It goes through school age and the the suggestions are practical and easily implemented.
Please go to the Guidelines Supplement for links to international Special Education resources.
Individuals with Disabilities Education Act (IDEA)
Website: www.ed.gov/offices/OSERS/Policy/IDEA/regs.htmlAmericans with Disabilities Act, Section 504
Website: www.hhs.gov/ocr/504.html\
Please go to the Guidelines Supplement for links to international Special Education resources.
This material is copyrighted by the Ocular Immunology and Uveitis Foundation, C. Stephen Foster, M.D., President. Readers are encouraged to redistribute this material to other individuals for noncommercial use and free of charge, provided that the text, HTML codes, and this notice remain intact and unaltered in any way. Uveitis: A Guide for Teachers and Parents may not be resold, reprinted or redistributed for commercial use or compensation of any kind without prior written permission from the author.
Suggested citations are listed below. If you have any questions about permission, please contact Dr. Foster.
President
Ocular Immunology and Uveitis Foundation
5 Cambridge Center (8th Floor)
Cambridge, MA 02142 USA
| Office: | (617) 742-6377 | Toll Free: (866) 742-6377 |
| Fax: | (617) 227-1185 |
| E-Mail: | fosters@uveitis.org |
| Web: | www.Uveitis.org |
Uveitis/OID Support Group |
|
| Voice: | (617) -797-1185 |
| E-Mail: | ffoster@mersi.us |
| Web: | www.Uveitis.org > Patient Information > Support Group |
WEB Edition
Foster, C. Stephen. Uveitis: A Guide for Teachers and Parents. Ocular Immunology and Uveitis Foundation, Cambridge, Massachusetts USA. http://www.uveitis.org/glossary/kids/school/guidelines.htm, (Date viewed: August 24, 2008).
Print Edition
Foster, C. Stephen (2004). Uveitis: A Guide for Teachers and Parents. Ocular Immunology and Uveitis Foundation, 348 Glen Road, Weston, MA. 02493, USA . Revised August 2005.
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Vision
will always be affected when there is inflammation inside the eye. How
vision will be affected depends on how severe the inflammation is, how
long the inflammation has gone uncontrolled, whether the student is
having a "flare" up of symptoms (whether the illness is active or in
remission), whether complications such as glaucoma or cataract have
developed, and what treatment the child is receiving. As you might
imagine, it can get pretty complicated. 
inflammation cells with a special
microscope called a slit lamp. Inflammation cells get into the fluids of
the eye because the surrounding structures in the eye, of the uveal
tract, have inflammation. The inflammation cells can be counted. The
cell count is one of the pieces of information the doctor uses to
determine how severe the disease is. 
ground
and athletic activities but must, at all times, take special precautions
to protect their eyes from injury. One parent's solution to her
daughter's refusal to wear protective eye gear during soccer was to buy
the whole team the same eye gear. Now, all of the kids want to have this
"equipment" 