In a child with juvenile rheumatoid arthritis, the eye examination shows presence of.
**Core Concept**
Juvenile rheumatoid arthritis (JRA), now known as juvenile idiopathic arthritis (JIA), is an autoimmune disease characterized by chronic inflammation of the joints. In addition to joint involvement, JIA can also have extrarticular manifestations, including ocular complications. The eye examination in JIA may reveal various signs of ocular inflammation.
**Why the Correct Answer is Right**
The most common ocular complication in JIA is uveitis, an inflammatory condition of the uvea, the middle layer of the eye. Uveitis can cause symptoms such as eye pain, redness, and vision loss. In children with JIA, uveitis often presents with anterior uveitis, which involves inflammation of the iris and ciliary body. The inflammation can lead to complications such as cataract formation, glaucoma, and retinal damage.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not correct because conjunctivitis is an infection of the conjunctiva, the membrane covering the white part of the eye, and is not a direct complication of JRA.
**Option B:** This option is not correct because retinal detachment is a complication of advanced uveitis or retinal disease, but it is not the most common ocular complication in JRA.
**Option C:** This option is not correct because optic neuritis is an inflammatory condition of the optic nerve, which can cause vision loss, but it is not a direct complication of JRA.
**Clinical Pearl / High-Yield Fact**
In children with JIA, regular eye examinations are crucial to detect uveitis early, as it can lead to severe vision loss if left untreated. The American Academy of Pediatrics recommends annual eye examinations for children with JIA to monitor for ocular complications.
**Correct Answer: C. Retinal detachment.**