BenEzra et al treatment considerations aiming at minimizing the severe ocular complications leading to rapid non-reversible loss of vision (BenEzra and Cohen 2000). In the present study, the ocular complications and relative incidence of intraocular inﬂammation in a cohort of 172 children with various types of JIA were evaluated during a period of 15 years with a minimum follow up of 3 years for each included patient. Patients and methods Children diagnosed with JIA were referred by pediatricians to our Immuno-Ophthalmology Unit for ophthalmic exami- nation. Children 10 years old or younger presenting to our clinic with intraocular inﬂammation were referred for pedi- atric consult to verify a possible JIA association. Included in this study is a cohort of 172 children with JIA who were examined with the slit lamp at least on three consecutive visits and followed for a minimum of 3 years and a maximum of 15 years after the original referral visit. At the time of initial examination, the children’s age ranged between 30 months and 15 years. These included 35 boys and 137 girls. All were diagnosed by pediatricians as having JIA either prior to their initial ophthalmic examination (152 patients) or after pediatric consult was sought following the initial detection of intraocular inﬂammation (20 patients). All 172 children fulﬁlled the criteria for the diagnosis of JIA: Children with arthritis of at least 3 months duration, less than 16 years old at the time of ﬁrst arthritic manifestation and without any other detectable cause for the arthritis. Clinical examination History of possible systemic disease and ocular manifesta- tions were carefully reviewed with the patients and parents. All patients underwent an ocular examination which included assessment of the visual acuity using the Snellen charts or the illiterate E charts and/or familiar pictures for the young verbal children. In a few of the very young and pre-verbal children, the pattern of ﬁxation for near and distance and the elicitation of optokinetic nystagmus were used to assess their visual functions (BenEzra and Rose 1990). Slit lamp biomicroscopy, thorough fundus examination and assess- ment of refractive errors in both eyes were performed in all cases. The intraocular pressure (IOP) using the Goldman applanation tonometer was obtained in cooperative chil- dren. In a few of the very young children with early ocular complications the IOP assessment, fundus examination and refraction data were obtained after sedation or general anesthesia. Ocular movement abnormalities, the presence 514 or absence of strabismus and the binocular functions were also routinely assessed. Ocular medical treatment Ocular medical treatment consisted on instillations of cor- ticosteroids and cycloplegic eye drops when the intraocular inﬂammation was conﬁned to the anterior segment. The frequency of eye drops instillations in these cases was arbi- trarily modulated for every affected eye according to the intensity of inﬂammatory reaction in the aqueous humor as assessed at the slit lamp. Systemic corticosteroids (up to 1.0 mg/Kg/day) and/or Methotrexate (up to 25 mg once a week) were prescribed if the intermediate and posterior segments demonstrated active inﬂammatory process or at the advice of the treating rheuma- tologist for the control of severe arthritic manifestations. Laboratory tests Complete blood count (CBC), sedimentation rate (ESR), C reactive protein (CRP), urine culture, kidney and liver function tests were performed in all cases. According to the clinical observations and the results of these routine preliminary examinations, a tailored individual more ardu- ous battery of tests was designed as necessary (Dick and Forrester 1999). Classiﬁcation of uveitis The type of intraocular inﬂammation (uveitis) was classiﬁed according to the anatomical site of the major inﬂammatory manifestations following the intraocular inﬂammation soci- ety guidelines (Forrester et al 1998; BenEzra et al 2000). The intraocular inﬂammation was further subdivided to whether the disease was strictly ocular or it was associated with a systemic disease. Systemic disease associations were determined according to established sets of criteria (Bloch- Michel and Nussenblatt 1987; Weiner and BenEzra 1991; Dollfus 1998; Forrester et al 1998; BenEzra et al 2000; BenEzra et al 2005). Results Of the 172 children with JIA, 152 were referred by pediatri- cians for ocular examination after the diagnosis of JIA was ascertained. In 20 children, intraocular inﬂammation was the presenting symptom while JIA disease was established later by a pediatrician. Of the 152 children with the presenting symptom of arthritis, 18 (11.8 %) had the systemic type of JIA, 87 (57.2%) had the pauciarticular type and 47 (30.9%) had the polyarticular type. Of the 152 children presenting with Clinical Ophthalmology 2007:1(4)