COSMETIC CONTACT LENS SUBSEQUENT TO PANOPHTHALMITIS IN SUSPECTED PAUCIARTICULAR EARLY ONSET JUVENILE RHEUMATOID ARTHRITIS

Etty Bitton

Abstract

A 6 yr old Caucasian female was referred for a cosmetic contact lens following a panophthalmitis OS. The patient was hospitalized at the age of 3 suffering from malaise, high grade fever, and generalized joint pain. At that time she presented with no light perception and an acute uveitis of the left eye. The right eye was unaffected. An intensive workup for suspected juvenile rheumatoid arthritis (Still's Disease) was undertaken. Such cases usually present with involvement of a few large joints and chronic iridocyclitis. She differed from this classic presentation due to acute unilateral uveitis and generalized joint pain. However, a diagnosis of pauciarticular early onset juvenile rheumatoid arthritis was made by exclusion. The patient is still being closely monitored although she has suffered no reoccurrences and requires no medication. Due to the panophthalmitis, the affected eye has no remaining visual function and suffers from globe retraction, an associated ptosis, decrease in the vertical palpebral fissure and pseudo- esotropia, and there is a cataract, band keratopathy, and heterochromia iridis. The patient has been fit with a hand painted iris soft contact lens to improve cosmesis prior to starting school at which time her appearance may become more of a social issue. She is also being considered for surgery to increase the orbital fat so as to move the globe forward.

Details

Year: 1992

Program Number: Poster 58

Author Affiliation: n/a

Co-Authors: Angela Kothe

Co-Author Affiliation: n/a

Room: Great Hall