A 5-year-old girl with oligoarticular juvenile idiopathic arthritis is ANA positive and rheumatoid factor negative. She has no eye complaints. What is the appropriate ophthalmologic management?

• A No eye examination needed unless she develops redness, pain, or photophobia
• B Annual fundus examination only after visual symptoms develop
• C Slit-lamp screening every 3 months for asymptomatic chronic anterior uveitis ✓
• D Prophylactic topical corticosteroids to prevent uveitis onset

Explanation

JIA-associated uveitis, especially in young girls with oligoarticular disease who are ANA positive and RF negative, is typically a chronic, bilateral, insidious anterior uveitis that is entirely asymptomatic because the eye stays white and quiet. Vision-threatening complications such as band-shaped keratopathy, cataract, glaucoma, and posterior synechiae develop silently. Hence scheduled slit-lamp screening at intervals dictated by risk stratification is mandatory. Symptom-based review (option A) is the classic trap, since symptoms are absent until damage is done.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.