Iritis, an introduction

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

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

clearing up

Post by deb beil » Mon Aug 07, 2006 7:07 pm

After 4 weeks of treatment, my iritis is clearing up. I have not used the dilation drops since Friday. My eye is less dilated but still coming off the meds. Still going to the specialist tomorrow to check for causal factors. Don't know what I would have done so far without this site. Even my opthamologist says iritis is a mystery although he has done a decent job of treating it so far. My brother is a pathologist but he says there is a great shortage of ocular pathologists and he admits he knows very little about the eye. Because of this site, I feel like I understand what has been happening in my eye and thus have felt a little less panicked. Will let you know if I find out anything interesting tomorrow.
Deb Beil

Mike Bartolatz
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Post by Mike Bartolatz » Wed Aug 09, 2006 12:12 am

I hope all is well tomorrow with your followup appointment. Glad our site has been of help to you too. as to 'pathology' of eye disease much of the cause of uveitis is of an autoimmune nature. it is rarely caused by a pathogen. this is why we suggest that our members who have difficult to control uveitis be treated by an Ocular Immunologist a fellowship trained opthalmologist often with a background of internal medicine or rheumatology. although ones tests are negative for some markers of autoimmune disease with the intial round to testing, often these will become positive a year or even a decade later in some individuals. Ocular immunologists are aware of this and test for possible relationships as symptoms start to present in their patients.

I wish you the very best,
Mike
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Ritchie
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Post by Ritchie » Tue Aug 15, 2006 5:59 am

Update!

Ok had another set back. It’s been two weeks after the laser surgery to fix the after cataract and for the first week things were sort of going well. The second week however no further sight improvement and towards the end was sure may have been getting worse.

Went for my check up yesterday and was told that swelling had developed on or around the macular. Had a special 2D scan (new machine apparently) which was able to print out pretty pictures and figures comparing my good eye to the bad. Good eye 232 and bad eye 272 approx. from memory.

Doc has kept me on the Maxidex and oral steroids. Now has added Acular to the list which is a non-steroid but is used to reduce the swelling inside the eye.

Doc says that we wait 6-8 weeks and hope the swelling goes down. (prey)

I’ve leant by now that when the doc tells you further complications may occur that you stand up and take notice. Says that corrigated rippling of this part of the eye could happen which doesn’t help in processing the light to create the vision.

At the moment no rippling has occurred. I’m not sure how long the swelling has been there. Also felt that even after the cataract operation that the sight would suffer in one way or another. I only hope the swelling has not been there for too long. Doc says the swelling has occurred because of the three operations. Makes sense as he said it was like having any other operation on the body, muscles usually swell around the operated area. Eg knee operation.

Further to all this, my one an a half year old son gave me conjunctivitis today in my good eye. Obtained some drops from the chemist and should be gone by morning. Not having a good day. I assume the drops that I am putting in my bad eye are staving off the infection happening in the good.

Mark

Mike Bartolatz
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Post by Mike Bartolatz » Tue Aug 15, 2006 1:03 pm

lets hope the cystoid macular oedema can be stopped quickly for you. your doctor is speaking about epiretinal membrane formation over the site of the oedema. the rippled surface is called macular pucker. I have this.
if the treatment doesn't accomplish the goal of stopping the Cystoid macular oedema, injection of corticosteroid into the eye can sometimes accomplish this. it is a last resort however.

hope the conjunctivitis goes away quickly too. I got a bout a few months ago from my grandson who gave me a bug that turned into a sinus infection and then it went into my lungs and into my eyes. required oral antibiotics to stop.

wish you the best,
Mike
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Ritchie
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Post by Ritchie » Tue Aug 15, 2006 6:25 pm

Found this quote on a web site when I searched for EPIRETINAL MEMBRANE.

"In most cases, little can be done to improve acuity." It did say surgical peeling of the membrane can be performed. I dont want to think about this.

The web site did'nt explain why this situation has occured. Is the reason why is because of the two bouts of iritis inflamation that i originally had or because of the filtering, cataract and after cataract operations?

Is it swelling like my doctor says, which implies to me that it may go down, or is it forming of cells and a layer that can only be stopped like the web site reads.

Thanks Mike.

Mike Bartolatz
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Post by Mike Bartolatz » Tue Aug 15, 2006 6:53 pm

surgical peel of the membrane is done only when vision has been compromised to a great extent. luckily mine only produce a small amount of distortion in small areas off center from my central vision. your eyes can learn to ignore this to some extent with one eye filling in the missing spot for the other eye so to speak. this is what my eyes do for other missing areas of vision due to past experiences with elevated intra ocular pressure from being a 'steroid responder.'
I don't know why some ERM's become macular pucker. they often form over areas of Cystoid Macular Oedema (Edema here in the USA).
the goal of treatment is to reduce the area of swelling as quickly as possible to prevent detachment of the retina and other changes withing the retina that can damage vision.

CME is a result of uncontrolled uveitis. it can take some time to occur.
do a google search on Cystoid Macular Edema as well as Cystoid macular oedema and articles should come up the Review of Opthalmology has an online textbook that you can access and read on various topics which will give more detailed information than Abstracts often provided in a normal Google search.
this is fluid build up not cells as it the case with oedema anywhere in your body.

take care,
Mike
Mike Bartolatz
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Ritchie
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Post by Ritchie » Wed Aug 23, 2006 7:57 pm

Update!

Going back to the Doctors tomorrow to determine whether 1 week’s worth of triple the amount of steroids has help my macular oedema. What I have discovered is if I try to view something from the top of the eye looking towards the ceiling, I can just read text on the computer screen. This as you can imagine was a massive discovery.

What does this suggest? Is this positive or is it something that I have just become aware of over time.

Mike Bartolatz
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Post by Mike Bartolatz » Wed Aug 23, 2006 11:45 pm

you will have to get input from your opthalmologist on this one as I have no clue what is going on.

good luck with your appointment tomorrow,
mike
Mike Bartolatz
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Ritchie
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Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Thu Aug 24, 2006 12:36 am

Sorry Mike yes a few things have happen since we last spoke about the CME last week. Will keep you posted when I get back from the doctors.

Mark

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

Post by Ritchie » Mon Aug 28, 2006 4:41 pm

Update!

Had appointment last Friday and things look to be on the mend. CME appears to be not as bad as first thought and can now start to ween the steroid medication down. No injection required at this stage. In fact it is now thought the asymmetrical macular shape is more because of the original iritis inflammation and may settle down over time.

Regarding the conjunctivitis, this is interesting. My good eye over the last couple of weeks has recorded eye pressures of 21 and 32. This is very concerning because over the least three years and through all the anguish of having 40+ pressure readings in my bad eye, my good eye never went over 12 or 13. Why was this so?

Well the doctors think that the high pressure readings are because of the conjunctivitis and the reason why the pressure is still normal in the bad eye is because the bleb is working so well. (I hope) This was good news and Doctors says pressure in good eye should return to normal in 4-6weeks.

In a previous posting Mike you mentioned “hope the conjunctivitis goes away quickly too. I got a bout a few months ago from my grandson who gave me a bug that turned into a sinus infection and then it went into my lungs and into my eyes. Required oral antibiotics to stop”

Well this is the same thing that is happening to me! I have been off work with the following symptoms:

Conjunctivitis – first good eye then bad eye, week to clear up for each.
Developed very tight wheezy chest toward end of second week and still have today.
Now have sinus inflection also, and on my second batch of oral antibiotics.

This is all most likely coincidental I know but I did speak with the doctor about whether I was more sensitive or susceptible to eye inflections given my predisposition to iritis and he said yes. Neither my wife nor daughter contracted the conjunctivus as evidence of this.

Anyway I just hoping the pressure reduces in the good eye as predicted in 4-6weeks. Mike, was the antibiotics that you took generally to clear up the sinus and chest inflection or was further related to the conjunctivus and eyes somehow and something that I should point out to the doctor?

Mark

Jess
Posts: 2
Joined: Sun Jun 11, 2006 5:28 pm

New To Forum

Post by Jess » Mon Aug 28, 2006 4:57 pm

Hi my name is Jessica and I am 25. I have had Iritis for one year. It started in the right eye then the following week it was in both eyes. I have been taking predforte to try to cure the iritis but all it does is keep it from getting any worse it is hard since i dont know anyone with iritis or even people who have heard of it. My dr's have put me through test after test all negative they dont know why i have irits its probably because all i have is iritis but they say you have to have something else but i guess what i am saying is i feel alone with this eye thing and would love to hear how others live with it or have gotten ride of it thanks Jess

Mike Bartolatz
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Post by Mike Bartolatz » Mon Aug 28, 2006 5:02 pm

I was given an antibiotic to clear up the sinus infection and the conjunctivitis. I was given doxycycline for 2 weeks. it did the trick and even helped with some blepharitis that was going on. I have severe dry eyes and can get infections very easily in them.

got some new lower collogen punctal plugs implaced today. they should last for another six months then I might get some silicone ones put in if all goes well. my upper ones disolved and they thought they would give my upper punctum a break. if I need to I can get them implaced as well.

Glad your CME is getting better but I hope that by lowering the steroid eyedrops your pressure in your 'good eye' will get a bit lower.

Wish you the best Mark,
Mike
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Ritchie
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Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie » Tue Aug 29, 2006 10:26 pm

2Jess

Fortunately I have not really had to live with iritis for longer than six weeks at a time. I have had two iritis flare-ups, both of which could be controlled with steroids. (Oral and drops).

Unfortunately however when they do appear it is really quiet serve with the last also requiring an injection of steroids directly into the eye. It sounds like if you still have iritis continually over a year it must be a milder case that seems to be more lingering around. (Still a pain however don’t worry I know)

Referring to past posts you will notice that I have a gene called HLA-B27+. People that have this gene seemed to have a predisposition to this condition. Can’t really add much more to it than that. I do feel however that stress may be linked to my individual episodes as I have a clear memory of major stress levels at these times. I not talking about being stressed for one day but maybe over a period of time. Say a month.

Really hope your iritis clears up.

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

Post by Ritchie » Tue Aug 29, 2006 11:09 pm

Mike you have thrown me a little. Your reference to lowering the steroid eye drops helping the pressure in the good eye has me concerned.

Are you saying that possibly by either taking oral or using steroid eye drops in my bad eye is possibly the cause or contributes to the high eye pressure I am currently experiencing in the good eye?

As a reminder I have never had iritis, pressure higher than 13 and have never used steroid drops in the good eye.

I am concerned that because I am a steroid responder, that taking oral steroids will effect the good eye as well. I prey that it doesn’t.

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

Post by Mike Bartolatz » Tue Aug 29, 2006 11:24 pm

oral steroids can have an effect on the intra ocular pressure of either eye. eye drops and injection will only effect the eye that has received them.
HLA B27 uveitis can ping pong between eyes in many instances.
there are other causes of increase intra ocular pressure such as glaucoma which can occur without uveitis being present. with uveitis the meshwork that drains the eye can become plugged from the cells and sometimes pigment shed from the iris. if the cilary body stops producing fluid it can also cause the pressure to go too low and that can damage the eye quickly too.

wish you the best,
Mike
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