New to Iritis and this forum

Post here to exchange iritis general information and support with others.

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smakelainen
Posts: 6
Joined: Thu Jul 22, 2010 9:06 am

New to Iritis and this forum

Post by smakelainen » Thu Jul 22, 2010 9:36 am

So here is my story:

I am a 22 year old female just starting my career. I was admitted to hospital in early June with a kidney infection, was treated with aggressive antibiotics and sent home. Within a week both of my eyes were bloodshot, so during my follow up appointment I mentioned it to the doctor who dismissed it as "something viral" and sent me home. After a couple days, things hadn't started to clear so I booked an appointment with my optometrist (I hadn't been introduced to the opthamology term yet) as I was experiencing blurred vision. He took a detailed look and diagnosed it as viral pink eye and sent me home with some artificial tears. Three days later the eye had gotten worse (now it was just predominately the right eye). I was experiencing extreme photosensitivity as well as increased redness. I did thorough research online and I was considering iritis as an option. This time I decided to go to a walk-in clinic (where my family doctor is employed) and the on-call doctor now diagnosed me with bacterial conjunctivitis and sent me home with garamycin antibiotic drops. However, he did mention possible iritis but said he was sure it was conjunctivitis; if it didn't get better to come back Monday morning and get a referral to the opthamologist in the clinic (best one in town; one of the only ones in town). So over the weekend I noticed that my pupil seemed stuck down and I sat in front of the mirror and played with the lights and confirmed this. At this point in time my vision was fairly impaired as well. First thing Monday morning it was back to the walk-in and a referral to the opthamologist was given with "iritis?" written on the page. After waiting another 3 hours, the opthamologist saw me; my vision at this point was about 20/100. The opthamologist confirmed iritis and sent me home with pred forte drops once every hours, maxidex ointment at night, and 2% dilation drops 4x a day. He said the vision loss was due to debris on the lens but that the back of my eye was clear and IOP was normal.

The following day, the vision got worse, the pain was worse. Back to the opthamologist I went, the vision now around 20/180. He said it had gotten worse overnight and to flush the eye with pred forte as often as possible for the following 24 hours (i.e. every 10-15 minutes), also to wake up at night and take them. I booked another appointment for the following day and got another vision test. However, this time I couldn't see the chart at all, they performed a 2 finger test and I was then 20/200 (legally blind) in my right eye. The good news is that I had no more pain that morning. The doctor brought me back down to once every hour and said to go back in 2 days. IOP was still normal.

After a week or so, I was instructed to bring the drops down to every 2 hours. Within 3 or 4 days the iritis had flared up again (although I wasn't legally blind anymore, but still had barely any vision). Back up to once every hour. A week later I saw him again and my vision was now 20/40 (Woohoo!). He told me to take them down again to once every 2 hours but if it got worse, bring them back up. The dilation drops at this point were now brought down to twice a day. I ended up bringing them up to once every 1.5 hours the next day and keeping it like that; the iritis seemed to start to heal. The following appointment, my vision again was worse again at 20/70. He now spoke about injections around the eye and said he'd give me a week to play with the drops and see if I could get it under control. My next appointment was booked at the hospital; he would take pictures and look at it through the slit lamp and decide from there.

That appointment was this past Tuesday. The pictures were taken, the slit lamp looked through and he said things were improving; although my vision was still the same at 20/70 or so. He hemmed and hawed about the injection and decided to give me half a dose of cortisone in that eye. I was instructed to take the pred forte still 4x a day, the dilation drops twice a day and the maxidex at night. He scheduled a CT scan for the following day (yesterday).

My vision still has not improved, but it seems that I can see better without my glasses (which are for distance) in that eye. Odd. Went to get the CT scan yesterday, but they took a variety of pictures (and a bunch of bright light flashes in my eyes, which turned white light into red afterwards.. the effects wore off within 5 minutes) and the doctor decided a CT scan was not required. He took me through the pictures and showed me my optic nerve inflammation. He asked if I had felt better and I said I saw my vision improving ever so slightly. I am back to see him Monday afternoon.

Today my vision hasn't been that great; it comes and it goes. Another thing I want to note is that when I get up in the morning and adjust to the light, I have 10 or so minutes of what seems like "black vision" although it is somewhat translucent. Should this be of any concern? I am starting to become frustrated with the, what seems like, slow improvement in vision. Has anyone else lost their vision to this extent and had the cortisone injection? What should I be expecting in the next couple of days or weeks? The doctor said I should see significant improvement by Monday, but at this rate, I can't see it happening.

Oh and upon all this, I started to get symptoms of arthritis. I am now being considered for Reiter's Syndrome and blood tests are under way.

Any guidance would be greatly appreciated. Thank you Mike for opening up this forum, it has helped me cope with this condition over the past 6 weeks! :D

Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: New to Iritis and this forum

Post by Mike Bartolatz » Thu Jul 22, 2010 12:38 pm

ask to be tested for the HLA B27 gene seen in uveitis as well as the sero negative spondyloarthropathies as well as the enteropathic arthropathies. these conditions are? ankylosing spondylitis, Reactive arthritis (formerly known as Reiter's syndrome but balanitis would be present genitally and with mouth sores) psoriatic arthritis, irritable bowel disease- crohn's and ulcerative colitis.
other genes to consider: IL23R. ERAP1, IL1R2 sometimes seen in ankylosing spondylitis, crohn's disease, autoimmune thyroid disease, SLE And MS and breast cancer.

other things to consider: Systemic Lupus Erthematosus which has a kidney component
tests for antibodies SSA and SSB and SMith Antibody. ANTI RO52 which an be seen in transeverse myelitis and Sjogren's syndrome. SArcoidosis. if optic neuritis is present, the NeuroMyelitis optica antibody test - NMO antibody.

You may NEVER get any of the things above so don't work yourself up. Most often uveitis is related to the HLA B27 gene without link to underlying disease. once the eye is quieted down, if it comes back, then one would try NSAID therapy through drugs such as Celebrex, Difusinal or Naprosy. DR Foster has about aq 70% success rate with NSAID therapy for autoimmune uveitis (HLA B27) also known as Ideopathic iritis.

Wishing you the very best,
Mike
Mike Bartolatz
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smakelainen
Posts: 6
Joined: Thu Jul 22, 2010 9:06 am

Re: New to Iritis and this forum

Post by smakelainen » Fri Jul 23, 2010 10:39 am

Thanks Mike, just waiting for the doctor to call me back. I am really not seeing much change in vision, probably still around 20/70 or 20/80. The doctor has made no indication that the vision will come back for sure; he just says "I hope so."

Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: New to Iritis and this forum

Post by Mike Bartolatz » Fri Jul 23, 2010 12:35 pm

The main thing is to stop the inflammation as quickly as possible. Many individuals gain vision back to where they were before uveitis as long as other changes don't occur inside the eye from corticosteroids or long term inflammation. watch for 'rainbow's' around lights which sometimes indicates increased intra ocular pressure, steroid induced glaucoma in which case you need to get in RIGHT AWAY for pressure lowering drugs. uveitis can also cause iritis wherein the drain inside the eye called the 'angle' plugs up and fluid can't get out from the inflammatory cells that settle out over time. sometimes pigment can be shed from the inflammatory process too which can cause the angles to get plugged up.

cataracts can also form from the disease and 'halo's around light's' is a symptom or starburst pattern.
any increase in floaters or large dots would also indicate need to get in right away not waiting for a followup appointment.

wish you the best,
Mike
Mike Bartolatz
Moderator

mtbargeman
Posts: 353
Joined: Fri Mar 09, 2007 8:41 am

Re: New to Iritis and this forum

Post by mtbargeman » Fri Jul 23, 2010 5:53 pm

Hi,

You may never get a specific underlying diagnosis to your Uveitis. Make certain that you pay attention to your color vision, as well. Can you see blue? Green? Red? Purple? Tell pink from orannge? This is an important clue to the health of your retina, and your eyes in general. Many people are never diagnosed with a specific underlying condition. I've had Uveitis since 2004.( That I am certain about, suspect longer) Undertreatment of my disease, along with a lot of crazy factors, led to blindness for me. I've been legally blind sinc 2006. The reason for that is that I did not get proper treatment soon enough. Make sure your eye doc knows about steroid-sparing approach, and how to treat your disease. If he doesn't, or doesn't want to explain things to you, or just throws you out his door with prednisone drops and dialating drops, look on the list found here on our board, and find a doc who specialises in Ocular Inflammatory Diseases. Also, you may want to see a Rheumatologist for testing and examination. If Immune Modulating therapy is required, such as methotrexate, you will end up seeing one, anyway. Rheumy's are more experienced in dealing with these drugs and their side effects.

Try not to worry. Try hard to reduce stress. These things can make Uveitis worse. Trust me.

Good Luck!

Mary

smakelainen
Posts: 6
Joined: Thu Jul 22, 2010 9:06 am

Re: New to Iritis and this forum

Post by smakelainen » Mon Jul 26, 2010 12:37 pm

Thanks for the advice Mary. Colours are fine, my doctor is very knowledgeable in this matter. I'm thinking it is now just a matter of time. The vision is not at its worst, but I am not seeing much improvement; either that or the improvement is just very gradual. I go back for a follow up appointment today, we'll see what he has to say. I just wish this would go away sooner than later. I am now on week 7.

Seija

mtbargeman
Posts: 353
Joined: Fri Mar 09, 2007 8:41 am

Re: New to Iritis and this forum

Post by mtbargeman » Fri Jul 30, 2010 6:40 pm

Seija-

It may be weeks before the meds are fully out of your system and vision recovers, esp. w/ dilating drops. That can be up to 6 or even 8 weeks. Take it slow, don't rush. Get some rest. It helps.

Mary

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