Incidence, management and outcome of raised intraocular pressure in childhood-onset uveitis at a tertiary referral centre

Br J Ophthalmol. 2019 Jun;103(6):748-752. doi: 10.1136/bjophthalmol-2018-312498. Epub 2018 Jul 18.


Background/aims: To investigate the incidence, management and outcome of uveitis and raised intraocular pressure (IOP) in children treated at the Manchester Uveitis Clinic (MUC).

Methods: This was a retrospective, observational study of patients who presented with uveitis under the age of 16 to the MUC from July 2002 to June 2016.

Results: A total of 320 children were included in the study. Out of these, 55 (17.2%) patients (75 eyes) were found to have raised IOP requiring treatment. The mean age at diagnosis of uveitis and at first recorded raised IOP was 8.2±4.3 and 10.8±3.6 years, respectively. The pre-treatment IOP was 32.3±6.6 mm Hg and the IOP at the final visit was 15.5±3.7 mm Hg (median follow-up period, 43.7 months) on a median number of 0 medications. Twenty-eight eyes (37.3%) required glaucoma drainage surgery, and eight eyes (12.5%) had cyclodiode laser before this. Kaplan-Meier analysis showed that 11.5% of eyes required glaucoma surgery at 1 year after diagnosis of raised IOP, increasing to 50.0% by 5 years. The best-corrected visual acuity at diagnosis of uveitis was 0.26±0.42 logMAR, which remained stable at 0.28±0.65 logMAR at final follow-up visit. Four eyes (5.3%) from four patients fulfilled the definition of blindness by the WHO criteria. The mean cup:disc ratio at final follow-up was 0.4.

Conclusion: Our cohort of children with raised IOP appeared to have a good outcome overall through aggressive medical and surgical management. Regular long-term follow-up is recommended, and early surgical intervention in eyes with uncontrolled IOP can prevent loss of vision.

Keywords: child health (paediatrics); glaucoma; inflammation; uveitis.

Publication types

  • Observational Study

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Child
  • Female
  • Follow-Up Studies
  • Glaucoma / epidemiology*
  • Glaucoma / etiology
  • Glaucoma / therapy
  • Glaucoma Drainage Implants
  • Glucocorticoids / therapeutic use*
  • Humans
  • Incidence
  • Intraocular Pressure / physiology*
  • Male
  • Prognosis
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data*
  • Tonometry, Ocular
  • United Kingdom / epidemiology
  • Uveitis / complications*
  • Uveitis / epidemiology
  • Uveitis / therapy
  • Visual Acuity*


  • Antihypertensive Agents
  • Glucocorticoids