Iritis, an introduction

Issues concerning developments in care of Ocular Inflammatory Disease and other noteworthy Items are contained in this forum.

Moderators: Mike Bartolatz, kwork

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Will it occur in my right eye

Post by Ritchie » Tue Jul 04, 2006 8:29 pm

Hi Mike, cannot say how much I appreciate you advice.

I am a 34-year-old male that has had iritis in my left eye twice over the last 2-3 years. As a result of the last inflammation high eye pressure developed and also a cataract. I have recently had filtering surgery and the cataract affected lens removed. I am now experiencing after cataract condition and my sight is not very good.

All the while through this I have been hopeful that my sight in the left eye would return to normal. I am beginning to realise that this may not be the case but yes I am always hopeful.

I simply ask the question, what is the likelihood of the other eye being effected by iritis if not effected by now?

I thankyou for your support. Finding this information has really helped.

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

Post by Mike Bartolatz » Tue Jul 04, 2006 8:52 pm

many individuals never get iritis in the 'other eye'.
your vision may well improve in the eye that has been operated on. for some individuals this can take time. the main thing is to stop the post surgery inflammation and to keep the intra ocular pressure down. because of the cataract surgery with renewed inflammation sometimes the lens capsule will opacify. the opthalmologist can use a YAG laser to blast a hole in the lens capsule allowing the 'pinhole' effect to allow you to see. I had to have this done with both cataract surgeries with excellent results.

hang in there, we pray your vision will improve soon.

TAke care,
Mike
Mike Bartolatz
Moderator

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Tue Jul 04, 2006 10:44 pm

wow that has given me renewed hope.

I have many questions but will keep things short, however your comment about the "renewed inflammation sometimes the lens capsule will opacify" leads me to believe that you assume I am experiencing inflammation.

I'm lead to believe by my doctor that the inflammation is really quiet at the moment. Because of my age, is the reason why the after cataract condition has occurred 1 week after surgery is because there is inflammation in the eye. I am currently taking panafcort tablets and maxidex drops.

I think I also read on your web site that after cataract conditions mainly occur in young children and the elderly.

Yes I am having the YAG laser in about a month’s time because the doc wants me to recover from the cataract surgery first. He also said the laser can trigger inflammation again. I not too concerned because I do respond well to the medication.

FYI the pressure is good and as I mentioned above I'm told the inflammation is quiet for the moment. I do live in good spirits and confidant that the sight will come back. I just concerned that the sight loss that I am experiencing now is the worst it has ever been over the last year, which has been bad enough.....

Mark

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

Post by Mike Bartolatz » Wed Jul 05, 2006 9:49 am

your lens capsule did opacify if you are having the YAG laser surgery. your vision should improve immediately after the YAG. if the eye does become inflammed then it might be a bit blurry until the inflammation can be controlled.

Wish you the best,
Mike
Mike Bartolatz
Moderator

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Wed Jul 05, 2006 1:14 pm

Thanks Mike.

For other people's benefit, yes I do have HLA-B27+ and have two close relatives that has serious Rheumatoid Arthritis.

What is the possibility that I too, may develop Rheumatoid Arthritis as well? My Aunty and grandmother developed this in their early forties.

Would it be wise to see a Rheumatoid Arthritis specialist even though I do not have any ailments?

Also, what is the possibility that iritis may be somehow be related to stress? I seemed to remember that just prior to the two bouts of inflammation I was under a lot of consistent pressure.

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

Post by Mike Bartolatz » Thu Jul 06, 2006 12:06 pm

it is impossible to say if you will develop arthriits. the most common form is ankylosing spondylitis but other things like psoriatic arthritis, reactive arthritis and GI problems like irritable bowel disease and Crohn's disease are predisposed by the HLA B27 gene.
stress does not cause uveitis but any major stressful event seems to bring on a new bout of uveitis. I for one have had this occur. it is impossible to prove this because stress is difficult to measure.

If I were you I would get a rheumatologist involved should you continue to have bouts of iritis as your disease problem is not just your eyes but is systemic autoimmune related and as such it must be treated systemically through the use of perhaps NSAIDS or immunomodulatory medications. often things like Celebrex, Voltaren, Indomethacin SR or Naprosyn work well in HLA B27 patients to stop the cycle of recurrent uveitis. if they fail to accomplish this then drugs like Methotrexate are used to help retrain the immune system to stop attacking your eyes. Rheumatologists are used to prescribing these medications and know how to monitor them for adverse effects. Methotrexate is used to control Rheumatoid arthritis and has had a very safe and effective history. there are other drugs to try as well should you not tolerate MTX.

wish you the very best,
Mike
Mike Bartolatz
Moderator

deb beil
Posts: 3
Joined: Fri Jul 21, 2006 3:37 pm

Trying to get in to specialist

Post by deb beil » Sun Jul 30, 2006 8:37 pm

Thanks Mike for your response to introduction posting. Your answer helped me feel less desperate and more patient. I have gotten my records sent to a specialist my brother knew of. Then I looked at the list of specialists at the Occular Immunitist and Uveitis Foundation site you had set up a link to and there he was. Dr. Russell Read in Birmingham, Alabama (only 2 1/2 hours away).

My visit to my local opthamologist this last Friday showed that the underlying iritis had not really improved although my iris is not stuck. The iris was occasionally sluggish in the last spot to break loose so I knew it wasn't gone by any means. He has started me back on continuous dilation drops and the steroid drops still 6 times a day. He was not upset that I had contacted a specialist, sent my records, and sounded willing to do follow-up treatment.

As far as I know, I do not have lupus, rheumatoid arthritis or any other auto-immune disease nor have I been exposed to any toxins that I know of. I have had several hypertension and allergy medication changes in the past few months. I have also begun using a c-pap machine for sleep aepnea. I saw on c-pap sites that occasionally pink eye can become a problem due to air leakage. Have you heard of anyone developing iritis due to a c-pap machine? I sure hope not because I am loving not stopping breathing 30-90 seconds several times a night.

Is it normal to have pains in your sinus area with iritis? I had them when I was light sensitive. I have only been slightly eye sensitive since I started the dilation and steroid drops.

Does it hurt your eye to use a patch if you are doing a lot of reading? Trying to focus with one eye dilated (and both eyes 50 yrs old and needing a new reading prescription anyway) has made me a very cranky person at work. I can read with my bad eye at this stage but it is more work and focuses in a different part of my glasses than the other eye, probably since my eye is so dilated all the time. I find myself closing that eye and then getting cramps in my facial muscles. I thought of getting a patch but didn't want to do something to harm my future vision.

Thanks again to you who monitor the site and provide such great information.
Deb Beil

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

Post by Mike Bartolatz » Mon Jul 31, 2006 1:35 pm

Sorry to learn of your additional health problems but they are most likely unrelated to your uveitis. Sinusitis can sometimes be related but as a consequence of things like Sarcoidosis. an infection anywhere in your body can trigger a renewed bout of uveitis but it is difficult to prove a causal relationship to the first attack.

glad your opthalmologist is willing to work with Dr Read in Birmingham.

as to patching the eye it shouldn't be a problem but please get input from your opthalmologist. In the past members have done this without any problems. just don't leave it on 24/7. a few hours at a time should be ok but I'm NOT A DOCTOR.

Hope you can break this chronic bout of iritis soon!

Wish you the very best,
Mike
Mike Bartolatz
Moderator

buzibea
Posts: 2
Joined: Tue Aug 01, 2006 8:10 am

Two year iritis attack

Post by buzibea » Tue Aug 01, 2006 8:24 am

Hi Mike. I am hoping you may be able to help. I suffered my first attack of iritis in Oct 2004. i am yet to be free of this attack - everytime the steroid drops are scaled down I make it to 2 drops a day, then within a few days the cell count is increasing again.
I have had all the blood tests etc which have so far not shed any light on why I have had such a severe attack.
I have once again had to increase my drops and dilate both eyes as the cell count has increased to 4 once again despite using 4 pred forte drops a day.
Is there any other avenues of treatment open to me, or anything I can do to help myself as I am becoming disenchanted with blurred vision, painful eyes etc etc etc.

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

Post by Mike Bartolatz » Tue Aug 01, 2006 9:27 am

yest there is hope IF you see an Uveitis specialist. this can be quite difficult to achieve there in the UK with the NHS system making it difficult to see such a rare opthalmologist. often either a virus like the herpes sx virus or an autoimmune disease process causes chronic uveitis. with their experience they can often tell what is the cause by looking at the eye through the slit lamp microscope. or they can persue other tests that can indicate what is going on and why.
I don't know where you live but there are several excellent ocular immunologists in your country. the one I would see if I lived there is Mr William Ayliffe at Croydon in London. his contact information can be found at http://www.uveitis.org in the patient information section on the INTERNATIONAL SPECIALIST LIST. there are several others available as well but MR Ayliffe is the best.

I hope this helps,
mike
Mike Bartolatz
Moderator

buzibea
Posts: 2
Joined: Tue Aug 01, 2006 8:10 am

Post by buzibea » Tue Aug 01, 2006 10:40 am

Thanks Mike for your suggestion - that sounds like the best way to go. As I have been seeing the same consultant at the Royal Eye Infirmary at Dorchester for past 22 months and he has yet to make this suggestion (I`m told to just keep taking the drops and hope!!!) which is all very well, however as I have 2 young children and work full time these constant periods of being unable to drive, poor vision are becoming tedious.

Do I ask my consultant for a referal, or is it better for me to contact the occular specialist direct?

Thanks once again for your help - all suggestions VERY gratefully received!!!!!!!!

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Tue Aug 01, 2006 8:10 pm

Update!

Hi Mike, thought I would let you know that I had the "after cataract" laser treatment done and so far so good. After 18 months of iritis, serious eye pressure, cataract and after cataract, it is good to be able to tell whether there is someone next to me on my bad eye side.

I am still not able to read with this eye though. Don’t worry I'm not so naive to think that my sight will come back instantaneously, especially when I have gone from 10% to about 80 % improvement in vision. However, can my sight be improved further with glasses, or is it common for someone that has experience the aforementioned conditions to lack the focussing power, even with the aid of glasses.

Cheers

Oh btw, there is no imflamation and the pressure is still down.

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

Post by Mike Bartolatz » Wed Aug 02, 2006 9:56 am

buzibea,

You can contact Mr Ayliffe for a an out of pocket appointment or you can go through your Primary care provider for a referal through the NHS system. MR
Ayliffe does practice within the NHS system as well but it can be difficult to accomplish if you are not within the 'local ' system.

please join the support group at http://www.uosg.org where others from the UK Post.
they can help you through this out of area referral process.

wish you the best,
Mike
Mike Bartolatz
Moderator

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

Post by Mike Bartolatz » Wed Aug 02, 2006 9:59 am

Ritchie,
you may be able to get improved vision with glasses. I wear them even though I have IOL' implanted.

glad your inflammation is under control too!

TAke care,
Mike
Mike Bartolatz
Moderator

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Wed Aug 02, 2006 1:22 pm

Oh wonderful Mike. Even though I have the implant it is good to know further refinement is still possible.

I would like to take this opportunity to thank my Iritis and Glaucoma specialist. I’m led to believe and also thru personal experience they are some of the best doctors in their field.

My advice to anyone that has iritis is to see a specialist and do not hesitate, even if it takes two hours to get there. This condition is a very spontaneous and in my case very rapid. They have saved my sight and for that I am internally grateful.

Mark

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