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Featured Article from the Immunology Service
Pediatric Uveitis

C. Stephen Foster, M.D.  
Professor of Ophthalmology, Harvard Medical School

Director of the Immunology & Uveitis Service
Massachusetts Eye and Ear Infirmary

Uveitis is the third leading cause of blindness in America, and 5% to 10% of the cases occur in children under the age of 16. But uveitis in children blinds a larger percentage of those affected than in adults, since 40% of the cases occurring in children are posterior uveitis, compared to the 20% of posterior uveitic cases in the adult Uveitis population.  

C. Stephen Foster, M.D., with Demi Miller at the  2001 Walk for Vision in Boston

There are, at any one time, approximately 115,000 cases of Pediatric Uveitis in the United States, with 2,250 new cases occurring each year. Spread across the entire U.S. population, therefore, and across all offices of Ophthalmic practitioners, the likelihood that any one individual practitioner will care for a patient with Pediatric Uveitis is relatively small, and the likelihood that any single individual will have significant experience in caring for large numbers of cases over a long period of time is vanishingly small.

This accounts, we believe, at least in part for the sub-optimal care that many of our children with Uveitis appear to be receiving, even in these "modern" times.  The stakes are incredibly high, for the child, for the parents who will be faced with (usually) many years of dealing with this health problem in their child, and for society at large because of the life-time of dependence which occurs in those who eventually reap substantial visual handicap as the result of sub-optimal treatment.

Eliza's great advice to other kids:  
"Don't be upset about having Uveitis.
You aren't alone."

We believe that current epidemiologic data emphasize two critically important goals in an effort to change the current prevalence of blindness caused by Pediatric Uveitis:

1. Repeatedly emphasizing to parents, ophthalmic practitioners, especially pediatricians, and school personnel, the critical importance of routine (annual) vision screening for all children. 

2. The critical importance of beating back the frontiers of general ignorance and mind sets, eliminating the all-too-common pronouncement by physicians to parents of a child with Pediatric Uveitis that:

     a.  "He'll (She'll) out grow it."  

     b.  "The drops will get him (her) through it." 

     c.  "It's just the eye; systemic therapy is not warranted."  

Statements (a) and (b) are true, but too often pull the doctor, and patient, and family into the seduction of nearly endless amounts of topical steroid therapy. It is generally true that the child will in fact "out grow" the Uveitis, i.e., that the Uveitis will no longer be a problem eventually. The pity is, however, that so often by the time the child "out grows it", permanent structural damage to retina, optic nerve, or aqueous outflow pathways have already occurred, and the blinding consequences are now permanent. It is also true that for any individual episode of Uveitis, the steroid drops usually will get the patient through it. But the fact is that so many children with Pediatric Uveitis have recurrent episodes of Uveitis such that the cumulative damage caused by each episode of Uveitis and the steroid therapy for each episode eventually produces vision-robbing damage.

And item (c) is simply the result of the common myopic viewpoint of Ophthalmologists: That it is just an eye problem, and therefore should simply be treated with eye medications. Nothing could be further from the truth!

And unless and until large numbers of Ophthalmologists reframe this socially and epidemiologically important matter, the prevalence of blindness secondary to Pediatric Uveitis is not going to change.

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Bridget and Meredith Quirk
Team Up for Uvietis Research

Bridget and Meredith Quirk carried the Olympic Torch on behalf of uveitis patients everywhere on 
December 27th, 2001 in Braintree, MA. 

The event gave birth to the Bridget & Meredith Quirk Fund at the Massachusetts Eye and Ear Infirmary.  The fund fights pediatric blindness by targeting research into the causes and treatment of childhood uveitis.  The Fund was established by Dan and Mary Jo Quirk in honor of their daughters, Bridget and Meredith, to fight pediatric blindness by raising money to purchase special laboratory equipment used to research inflammatory diseases of the eye such as uveitis.  Uveitis is an illness that blinds thousands of children and adults every year in this country.  The Fund supports the groundbreaking research that is carried out by C. Stephen Foster, M.D., Director of the Ocular Immunology Service and Laboratories at Massachusetts Eye and Ear Infirmary in Boston.  Dr. Foster is a Professor of Ophthalmology at Harvard Medical School and the author of over 600 publications. 

The Quirk family's first goal for the fund was to purchase a Heidelberg confocal laser scanning slit lamp biomicroscope.  Through the help of generous donors that included local businesses, family, and friends, over $127,500 was raised for the fund, accomplishing the goal of purchasing the laser scanning slit lamp biomicroscope.   We, Dr. Foster, the Uveitis/OID Support Group, and Massachusetts Eye and Ear Infirmary, are all deeply touched and grateful for the efforts of Mr. and Mrs. Quirk and Bridget and Meredith in raising this money to fight uveitis and ocular inflammatory diseases.  Mr. and Mrs. Quirk did this  not only for their daughter, Bridget, but for all patients who suffer with an ocular inflammatory disease.

If you would like to make a donation to the Bridget and Meredith Quirk Fund at MEEI, contact Barbara Erickson in the Development Office.  Donations to the fund support research into uveitis and other destructive inflammatory diseases of the eye.

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ONLINE SUPPORT FOR KIDS AND PARENTS THROUGH THE IMMUNOLOGY SERVICE WEBSITE

The Immunology Service and Uveitis Support Group co-sponsor online support and information resources for kids and for parents. For kids, join Emily and Kim and Demi and Peter and Michael, and Kasi and Bridget and others online at Uveitis Kids-MEEI.  The kids board is moderated by Liz Irvin and Dr. Foster.

And, parents have their own spot on the web at Uveitis Support-MEEI. 

In a recent interview, Dr. Foster said, "I am extremely pleased with the success of our online resources for adults and for children, especially with the quality of support and information that members are able to provide each other".

Member Exchange:
What Our Members are Saying Online

Dear Kristen,  

I just read your post. You have had uveitis since you were 7?   How is your vision now?   Have you been on medication the whole time?  How often do you flare?  Sorry for all the questions, I am just curious to hear from someone who has had this for such a long period of time. 

Thank you! 

Tricia (parent of a young child with uveitis)  

_____________

Hi Tricia, 

I have had uveitis since I was 7 (only in one eye). My vision in the doctor's office is 20/60 but out in the world it is more around 20/80. I have been on medication since the first time I complained of "seeing colors". I used to flare infrequently (2-3 times/year) and these flares would clear up quickly with steroid drops. Then my flares became more frequent and severe, and steroid pills and shots were tried. I saw the same ophthalmologist for 14 years who only wanted to treat me with steroids. I have a host of vision problems from chronic inflammation and chronic steroid use. Finally, I saw a uveitis specialist, and began methotrexate (MTX). I also have a new, more modern, local doctor. I have been on MTX since August and my 2.5 yr chronic flare has completely vanished, and my vision has gone from worse than 20/200 to 20/60. I have had acute glaucoma attack, macular edema, cataract, completely adhered pupil, and several other issues from chronic inflammation/steroid use. I wish I or my parents would have known about MTX years and years ago.  

Kristin (20 year old college student)

Support our Mission

The Uveitis/OID Support Group is a patient education and mutual support resource founded in 1996 by faculty, staff and patients of the Ocular Immunology & Uveitis Service at the Massachusetts Eye and Ear Infirmary in Boston.  Our mission is to educate patients and their significant others about ocular inflammatory disease and to facilitate the exchange of information, emotional support, and mutual aid between members.  We are also deeply committed to raising funds to support research into the causes and effective treatment of uveitis.

We are excited about what is going on in "Group".  And, we are determined to keep our resources, programs, and publications free of charge and accessible to anyone living with uveitis.  Support Group expenses are funded entirely through voluntary tax-deductible contributions to the Uveitis Support Group Fund at MEEI and by a sustaining grant from the Ocular Immunology Service at MEEI.

You can help by volunteering time and by making a contribution to the Fund.  Want to help  sponsor an edition of our Newsletter? This issue cost $500 to produce and mail.  Want to be a sponsor of the Kid's Conference?  Want to volunteer time?  If you want to get involved, please contact Liz Irvin, or leave a message for her at (617) 254-2815. 

Tax deductible contributions to the Support Group Fund are welcome any time: 

Make a check payable to:  Uveitis Support Group Fund at MEEI

Mail your donation to our support person in the Development office:

Melissa Paul    Melissa_Paul@MEEI.Harvard.edu
MEEI-Development Office
243 Charles Street
Boston, MA 02114  

Donations to the Support Group Fund are 100% tax-deductible, and 100% of contributions go directly to support the outreach and programs of the support group.   Every penny, 100%!

GET INVOLVED, ANY WAY YOU CAN  

Check out What's Happening at the Immunology Service Website

Did you know that the Ocular Immunology Service at MEEI has a website?  It is designed as a resource for physicians and patients alike.  There are over 50 articles published on the website that were written especially for patients and their family members by Dr. Foster.  Check it out.  Here's what to do:

1.  Point your web browser to www.uveitis.org

2.  Enter the site and select your choice from the extensive menu

The Support Group has its own section.  And, there is a terrific new Illustrated Uveitis Glossary developed by members and Dr. Foster.  Look up terms there, link to references about various topics.  The Glossary is suitable for all ages.  

NEW UVEITIS GLOSSARY GOES ONLINE

Under the direction of C. Stephen Foster, M.D., the Immunology Service and Support Group have published the  Uveitis Glossary on  www.uveitis.org .  The Glossary, designed as an educational tool for patients and family members, contains definitions for over 100 terms related to how the eyes function, the anatomy of the eye, and facts and information about ocular inflammatory disease in its many forms.  There are extensive illustrations and links to the best information we could find on the world wide web.  Happy surfing. 

The Glossary Quiz

Q.  What is anterior uveitis?

A:  Anterior uveitis means inflammation in the anterior (front) geographic area of the eye (boxed area), bounded by the cornea anteriorly and the iris posteriorly.  This inflammation derives primarily from inflammation of the iris.

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