International Ophthalmology

, Volume 38, Issue 5, pp 2061–2068 | Cite as

Patterns of uveitis in children at the apex institute for eye care in India: analysis and review of literature

  • Brijesh Takkar
  • Pradeep VenkateshEmail author
  • Nripen Gaur
  • Sat Pal Garg
  • Rajpal Vohra
  • Supriyo Ghose
Original Paper



To study patterns of uveitis in Indian children and compare with data sets published earlier in the literature.


Consecutive patients below 16 years of age presenting to the uvea clinic of a tertiary eye care center were included prospectively through the period of July 2009–August 2013. Children with retinal vasculitis, exogenous endophthalmitis and masquerade syndromes were excluded from analysis. Uveitis was classified as per the nomenclature system adopted by the International Uveitis Study Group. Hemogram, Mantoux test and chest X-ray were done for each patient, along with tailored investigations and pediatric review as per clinical profile. Clinical pattern and etiology were the main outcome measures.


One hundred and thirty-four children were analyzed. Anterior uveitis (40%) was the commonest pattern followed by intermediate uveitis (25%), panuveitis (18%) and posterior uveitis (17%). Bilateral disease was present in 54%, 15% had infectious uveitis, 10% had granulomatous uveitis and 54% had idiopathic uveitis. Complications were present in half of the patients. Juvenile idiopathic arthritis (22), followed by toxoplasmosis (10) and tuberculosis (5), was the commonest etiology. Intermediate uveitis, non-granulomatous inflammation and older onset of disease had the high odds ratio of having idiopathic disease.


Patterns of pediatric uveitis can vary between regions from even within the same geopolitical region. Anterior uveitis is commonest, and juvenile idiopathic arthritis and toxoplasmosis are the most frequent etiologies. Diagnosis of pediatric ocular tuberculosis is more difficult than in adults and needs better and well-defined criteria.


Intraocular tuberculosis Pediatric uveitis Idiopathic uveitis Uveitis in childhood 



The authors acknowledge Mrs. Veena Pandey for revision of statistical analysis.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Sauberan DP (2010) Pediatric uveitis. Int Ophthalmol Clin 50:73–85CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Gautam N, Singh R, Agarwal A et al (2016) Pattern of pediatric uveitis at tertiary referral institute in North India. Ocul Immunol Inflamm 21:1–7Google Scholar
  3. 3.
    Hersh AO, Cope S, Bohnsack JF et al (2016) Use of immunosuppressive medications for treatment of pediatric intermediate uveitis. Ocul Immunol Inflamm 14:1–9CrossRefGoogle Scholar
  4. 4.
    Narayana KM, Bora A, Biswas J (2003) Patterns of uveitis in children presenting at a tertiary eye care centre in south India. Indian J Ophthalmol 51:129–132PubMedPubMedCentralGoogle Scholar
  5. 5.
    Venkatesh P, Gogia V, Shah B et al (2016) Patterns of uveitis at the Apex Institute for Eye Care in India: results from a prospectively enrolled patient data base (2011–2013). Int Ophthalmol 36:365–372CrossRefPubMedCentralGoogle Scholar
  6. 6.
    Sen DK (1977) Endogenous uveitis in Indian children: analysis of 94 cases. J Pediatr Ophthalmol 14:25–32PubMedPubMedCentralGoogle Scholar
  7. 7.
    Rathinam SR, Namperumalsamy P (2007) Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol 55:173–183CrossRefPubMedCentralGoogle Scholar
  8. 8.
    Ganesh SK, Bala A, Biswas J et al (2016) Pattern of pediatric uveitis seen at a tertiary referral center from India. Ocul Immunol Inflamm 24:402–409PubMedPubMedCentralGoogle Scholar
  9. 9.
    Deschenes J, Murray PI, Rao N, Nussenblatt B (2008) International Uveitis Society Group (IUSG) clinical classification of uveitis. Ocul Immunol Inflamm 16:1–2CrossRefGoogle Scholar
  10. 10.
    Venkatesh P, Badduri Lodha R et al (2014) Uveitis prevalence and risk factors in juvenile rheumatoid arthritis—a prospective, Cross Sectional Study. Ann Paediatr Rheumtol 3:158–162CrossRefGoogle Scholar
  11. 11.
    Perkins ES (1966) Pattern of uveitis in children. Br J Ophthal 50:169–185CrossRefGoogle Scholar
  12. 12.
    de Boer J, Wulffraat N, Rothova A (2003) Visual loss in uveitis of childhood. Br J Ophthalmol 87:879–884CrossRefPubMedCentralGoogle Scholar
  13. 13.
    Edelsten C, Reddy MA, Stanford MR et al (2003) Visual loss associated with pediatric uveitis in English primary and referral centers. Am J Ophthalomol 135:676–680CrossRefGoogle Scholar
  14. 14.
    Kadayifcilar S, Eldem B, Tumer B (2003) Uveitis in childhood. J Pediatr Ophthalmol Strabismus 40:335–340PubMedPubMedCentralGoogle Scholar
  15. 15.
    Azar D, Martin F (2004) Paediatric uveitis: a Sydney clinic experience. Clin Exp Ophthalmol 32:468–471CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Hamade IH, Al Shamsi HN, Al Dhibi H et al (2009) Uveitis survey in children. Br J Ophthalmol 93:569–572CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Paroli MP, Spinucci G, Liverani M et al (2009) Uveitis in childhood: an Italian clinical and epidemiological study. Ocul Immunol Inflamm 17:238–242CrossRefPubMedCentralGoogle Scholar
  18. 18.
    Rahimi M, Mirmansouri G (2014) Patterns of uveitis at a tertiary referral center in southern Iran. J Ophthalmic Vis Res 9:54–59PubMedPubMedCentralGoogle Scholar
  19. 19.
    BenEzra D, Cohen E, Maftzir G (2005) Uveitis in childhood. Br J Ophthalmol 89:444–448CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Matoussi N, Ben Slima S, Fitouri Z et al (2007) Uveitis of children: a report of 18 cases. Arch Pediatr 14:856–860CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Paivönsalo-Hietanen T, Tuominen J, Saari KM (2000) Uveitis in children population-based study in Finland. Acta Ophthalmol Scand 78:84–88CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Smith JA, Mackensen F, Sen HN et al (2009) Epidemiology and course of disease in childhood uveitis. Ophthalmology 116:1544–1551CrossRefPubMedCentralGoogle Scholar
  23. 23.
    Venkatesh P, Takkar B et al (2017) In response to: “Gautam N, Singh R, Agarwal A, et al. pattern of pediatric uveitis at a tertiary referral institute in North India”. Ocul Immunol Inflamm 11:1. doi: 10.1080/09273948.2016.1269933 CrossRefGoogle Scholar
  24. 24.
    Herbort CP, Rao NA, Mochizuki M et al (2009) International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop On Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm 17:160–169CrossRefPubMedCentralGoogle Scholar
  25. 25.
    Ang M, Chee SP (2017) Controversies in ocular tuberculosis. Br J Ophthalmol 101:6–9CrossRefPubMedCentralGoogle Scholar
  26. 26.
    Rosenberg KD, Feuer WJ, Davis JL (2004) Ocular complications of pediatric uveitis. Ophthalmology 111:2299–2306CrossRefPubMedCentralGoogle Scholar
  27. 27.
    Gharai S, Venkatesh P, Garg S et al (2008) Ophthalmic manifestations of HIV infections in India in the era of HAART: analysis of 100 consecutive patients evaluated at a tertiary eye care center in India. Ophthalmic Epidemiol 15:264–271CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Retina and Uvea ServicesDr R P Centre for Ophthalmic Sciences, All India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations