Blurry vision

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Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Blurry vision

Post by Silverstar »

Hi,

Hoping someone can give me some reassurance or some advice here!

I started having problems with my eye about a month ago – after a cold, my left eye started developing prominent blood vessels and was aching. My optician initially thought it was probably episcleritis, but when it got worse and became very photosensitive and painful a couple of days after seeing her, she sent me to the local eye hospital, who diagnosed me with iritis. I was given Maxidex drops, and told to take them for four weeks – six times a day for a week, then four times, twice and once per day, to wean myself off them. I wasn’t given any dilating drops.

The pain and redness went away very quickly, almost overnight, but about two days after starting to use the drops, I woke up with very blurred vision in my left eye. I was sent back to the eye hospital, and they examined my eye with the slit lamp, dilated it and scanned the back of my eye, and checked the pressure. I was told that my eye looks completely normal and they can’t see anything that might be causing the blurriness, so it may be the steroid drops that are causing the issue and that I should keep using them as prescribed for a month, and then go back to the hospital if it hasn’t improved.

It has got better than that first day, but it’s still blurred to a noticeable extent, and I can’t tell if it’s still slowly improving. I had another appointment with the optician and she says it doesn’t seem to be something she would be able to correct completely with a new prescription, which makes me concerned if it isn’t the drops that are causing it. I’m currently down from six drops a day to four drops a day, and will taper off again in another three days.

Symptoms of the blurriness are:

less noticeable when I’m sitting in bright overhead light or am outside in daylight, more noticeable in dimmer light or when there are directional lights nearby.
haloes around directional bright lights
my vision does seem to improve pretty much back to normal when looking through a pinhole occluder
oddly enough, my close vision in my ‘bad’ eye seems to have improved! I can bring text closer to my left eye before it blurs than I can with my right ‘good’ eye, and I don’t believe that was the case previously

It does in many ways seem like a prescription problem, but as I said, my optician tried doing a sight test on me and said she wasn’t able to completely correct it with new lenses.

At the moment, I’ve been told to just wait until I come off the drops, and then I have another optician appointment a few days after I finish them, and then I assume I’ll be sent back to the eye hospital if it still hasn’t improved.

I was just wondering if anyone else has had anything similar, and if they were given a reason for what happened? Did it turn out to be the steroid drops and wear off? If so, how long did that take? Did it turn out to be something else that I ought to be looking into, as my healthcare providers are currently just on a ‘we're not really sure, so let's wait and see what happens’ plan, seemingly?

Thanks in advance for any replies.
kwork
Posts: 47
Joined: Fri Feb 06, 2004 12:30 pm

Re: Blurry vision

Post by kwork »

The eye drops can definitely be causing the issue. If they aren't see any additional inflammation in the eye, I would say the drops are the problem and will eventually clear up as long as the iritis didn't cause any long term vision problem.
Iritis.org Administrator
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

The prior inflammation and steroids will affect your vision for quite awhile. My presbyopia improved temporarily also. If u sleep on eye it can make vision blurry in morning. You seem to have mild iritis so your vision wont be permanently affected. Print snellen eye chart off net and monitor eye sight.
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Thank you both for the reassurance! I'm guessing it was a fairly mild case as it responded so quickly to the drops, and so far there's been no sign of any recurrence or flare up. I'm tapering down to two drops a day tomorrow, so fingers crossed that it all stays quiet and the lower dose means that my vision may slowly start coming back to normal. I know I'm lucky that the blurriness isn't so bad that it's causing any real day to day problems (except feeling mildly less comfortable driving in the dark), but it is extremely annoying!

Is there anything I should watch out for as my dose of steroids gets lower again? The switch from six drops a day to four didn't cause any issues, but I'd like to be aware of anything that might indicate problems as I taper off again.

Thanks again
kwork
Posts: 47
Joined: Fri Feb 06, 2004 12:30 pm

Re: Blurry vision

Post by kwork »

That's great news. Everyone is different in how they respond. I like to do the focus test where I focus on a distant object and then a close object (reading distance). Doing this quickly would always cause some pain when I had an episode coming on or recurring. Any slight increase in redness around the iris is another sign.
Iritis.org Administrator
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Wonderful, thank you. I'm starting my two drops a day regimen today, so I will do some focusing tests as I go along to check what's happening. I know my left eye tends to be dry as well, so I'm using lubricating drops regularly (I usually wait at least half an hour after using the Maxidex before putting them in), and that is also helping my eye feel better.

Just hoping that I'll be able to go back to contact lens wear soon enough. I'm going to look at switching from monthly to daily lenses, I think, as my doctor seemed to think too much contact lens wear may be what caused the flare up in the first place, so switching to dailies and wearing them less often will hopefully help to prevent another bout.

Thanks again.
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Hi again,

So I came off the Maxidex drops last Thursday, and for the most part, my eye has seemed fine. My vision is much better, though not quite back to normal yet, but I'm hopefully it will keep improving now I'm off the drops entirely.

I did have a question: Each time I tapered down, a few days later, my eye would become ever so slightly red and achy. This would wear off by the following day, and then it would be fine. I assumed that this was a side-effect of tapering, as my eye got used to the lower dose.

Today, four days after finishing the drops, my eye is again mildly achy and with a slight red patch at the bottom (the bottom of my eye, not the iris). Should I assume that this again will be just a side affect of coming off the drops, or is it likely that it's a flare up again? It's not painful like it was before, just slightly achy, and there are no problems when I focus and no photosensitivity.

What generally happens when you taper from steroid drops? Are there usually side-effects like I've described above, while your eye gets used to it, or should I be concerned?

Thanks again
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

I have very aggressive iritis and i really have not experienced a reaction to tapering. I went from 24 drops to 6 with no red or aches. I did tend to have redness in morning bevause the steroid ointment
Would not last the night. Taking the steroid causes a bit of blurred vision. Im still puzzled by the mild iritis experience. For me a red patch would mean
Return of inflammation. Not sure why you have not been monitored more. I would see a doc to clarify the situation. Yet you cleared up each time. I guess the steroid affects you more than it does me. The eye does have to start making more of its own steroid at some point during tapering. Too bad no one with mild iritis will chime in.
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

You can definitely have inflammation without photosensitivity or any pain/sensation when moving iris.
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Hi vancouver,

Thanks again for the reply. It seems to have settled down again today - the red patch at the bottom of my eye seems to have faded, and it's not really aching. Maybe it is just the way my body reacts to steroids. Oddly enough, the slight achiness often seems to happen right before my eyesight improves slightly, as though it's my eye sort of settling back into the routine of a lower steroid dose and changing shape slightly. The blurriness does again feel a little less blurry today.

Maybe I'm just weird!

I was surprised that the doctors didn't want to see me more, once I started reading this forum and realised how regularly most people were seeing their doctors. Mine just gave me the drops and told me to come back if there were any issues. But maybe it's because it seemingly was so mild? I don't know.
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

That sounds good. I was surprised by how long you tapered. I only tapered 12 days and i was on hourly drops for 2.5 weeks. Part of tapering i guess is maintenance to ensure the inflammation is not given chance to rebound. Id still take red patches seriously and inform doctor.:)
Silverstar wrote:Hi vancouver,

Thanks again for the reply. It seems to have settled down again today - the red patch at the bottom of my eye seems to have faded, and it's not really aching. Maybe it is just the way my body reacts to steroids. Oddly enough, the slight achiness often seems to happen right before my eyesight improves slightly, as though it's my eye sort of settling back into the routine of a lower steroid dose and changing shape slightly. The blurriness does again feel a little less blurry today.

Maybe I'm just weird!

I was surprised that the doctors didn't want to see me more, once I started reading this forum and realised how regularly most people were seeing their doctors. Mine just gave me the drops and told me to come back if there were any issues. But maybe it's because it seemingly was so mild? I don't know.
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Hi vancouver,

My eye was feeling tender again today, so I took your advice and went to get it checked out. I went to Moorfields this time, rather than my local hospital, as it's closer to where I work. The doctor there said that the inflammation hadn't completely gone, and he's put me back on the drops for another six weeks, plus a dilating drop for a week and some steroid ointment for overnight. Plus he's sent a referral letter to my GP to get me another hospital appointment in about eight weeks.

Hopefully that will clear it up properly now! Glad I listened to you, though I'm not looking forward to the blurred vision again, right as it had got pretty much back to normal.

Just wanted to say thanks.
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

Dilating drops might be overkill. They will blur your vision
Big-time. I'd ask what your cell count is. Dilating drops are to stop the iris sticking to lens. Also to reduce pain.
Maybe just weak dilation? I was on cyclopentolate 1%.
Ointment also might be overkill for mild iritis. Do u have scar tissue from iris sticking? I doubt it.

One doc said he only lowers dose if there are no return of symptoms. The red returning each time you lowered dose may have indicated you were tapering too fast.

I would assume that your cell count went to zero quickly last time and that is why you were not MOnitored. It is good to get cell count to zero quickly. The ointment would help that and ensure no rebound at night, but might be overkill. The doc may not know your iritis is mild?
Make a point of asking for cell count.

This being said, you also want to hit the iritis hard regardless of cell count. I've heard hourly for week minimum but that might be too much for mild iritis.

Wishing you good results.
Silverstar
Posts: 7
Joined: Mon Oct 03, 2016 5:52 am

Re: Blurry vision

Post by Silverstar »

Hi all, me again.

So this cleared up at the end of last year, which was great.

I woke up yesterday with the same eye feeling achy and mildly photosensitive again, as well as starting to get a little red around the iris. Obviously, I immediately was concerned that this was coming back again, so after umming and aahing for an hour or two, took myself off to Moorfields Eye Emergency room to get it checked out.

They did all the usual tests - pressure, dilated my eyes, slit lamp - and I explained that I was concerned it may be iritis again as it felt very similar to last time. However, apparently, they were unable to see anything wrong with my eye - no inflammation, no cells or anything. They also couldn't see any infection or damage that might explain the issue either. I've been told that there is nothing wrong with my eye as far as they can see, and to just not wear my contacts for a few days and it should be fine.

My question to you all is: once the eye starts to ache and become photosensitive and so on, should it be obvious to the doctor who is examining my eye? It does feel very similar to last time. Is it possible to have iritis, but for a doctor who is specifically checking for that to not see any signs of it? Therefore, is it possible that this IS iritis, but that even though there are outward signs, it's not progressed enough to show up when being examined?

Or should I just work on the assumption that it isn't iritis, and just wait for it to wear off?

I'm just concerned that if it is a flare-up of iritis again, I want to start treating it immediately.

Any help gratefully received.
vancouver
Posts: 153
Joined: Sat Oct 24, 2015 2:04 pm

Re: Blurry vision

Post by vancouver »

There would b white blood cells if eye is red and photosensitive. Some people know they have iritis before cells appear. They feel a sensation in eye. If eye goes blurry or you see lots of new floaters when looking at white sky, worry.


It would be obvious to an opthomologist. Normal docs can't read slit lamps well,however.
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