Hi all

[jscott]

Hi all

I am a 33 year old male. I had my second case of iritis a month ago. So, now that it appears this is most probably going to become part of my life, I though it best to get access to good information.

Some history:

My first case occurred about a year and a half ago, starting one day at work. Initially the symptoms were somewhat mild: some localized redness from the inner corner of my eye to the iris, sort of like a thin band; a mild ache; and some photophobia. I visited a GP at the clinic near my work and the doctor diagnosed it as pink eye and prescribed some drops. A few days later, things hadn't improved, and the symptoms intensified. So, I went to an opthamologist. He also didn't diagnose it as iritis at first, rather feeling it was an infection, and prescribed some drops and a cream. Then, a few days later things felt really bad and I went back, and then he mentioned iritis and treated it accordingly. It got under control rather quickly.

The most recent case started while I was flying to the U.S (I am an expatriate working in Singapore). Again, it started off slow with some redness developing the same way as in the first case, but in the other eye. While in transit in Japan, I actually went to an opthamologist there as I was starting to feel a little bit of an ache. There was a bit of a language barrier, but she was able to rule out iritis, and mentioned that it was a mild inflammation. She prescribed some steroid eye drops. When I arrived in the U.S I went to check in with an opthamologist, and he too ruled our iritis and said also that it was a mild inflammation. For four days I took the drops, then stopped, but the redness kicked in again with some more mild aches. I went back, and finally he saw the iritis. He treated it accordingly - a drop of omnipred every 2 hrs for 2 days/4 times a day for a week/3 times for a week/2 times/1 time. It pretty much cleared after a week, but he wanted me to taper off. Because it was my second case, he ran some blood work to explore causes. All markers for the systemic diseases he checked for came back negative, but I tested positive for HLA-B27.

Back in Singapore, I went to see a specialist, someone from your list - Professor Chee. My eyes are in working order, and nothing seems to be showing up with regards to complications from the two cases. I updated the doc on my history and she reviewed the blood work. She seemed to think that it is just the HLA-B27 that is causing my iritis, and based on the blood work and my not showing any other symptoms, that there is no need to further investigate causes at this stage. Nobody in my family has iritis, or any of the systemic diseases usually listed. She also seemed to think my cases are really mild and nothing really to worry about compared with others she has. I still worry though; I am a worry wart and can get anxious. I am still on one drop a day for 7 days, and I will go back and see the doc in 4 weeks.

So, that's it. I am definitely not happy that this is going on, but on the bright side it seems that my cases come on slowly, and don't hit as hard as others. I certainly worry about the next time it happens, and am trying to think of ways to prevent another attack, but from what I read, there isn't a way.

Jeff

[Mike Bartolatz]

Welcome to the group!
yes there is a way to help keep the recurrent HLA B27 uveitis from coming back, NSAID therapy. Oral NSAIDs taken at prescription dose could prevent reoccurance of the iritis. drugs of choice, Celebrex, Dolobid - difusinal, Naprosyn. you would know in about six months if it will work for you. then you would continue taking the oral NSAID for TWO YEARS to retrain your immune system to stop attacking your eyes, then if the stay quiet for the two year period then you would halve the dose for six months and then stop.
early systemic therapy works the best when NSAIDs are tried. if you wait until the iritis does damage, then you might have to go to chemotherapeutic immunomodulatory drugs of the DIsease Modifying Anti Rheumatic drugs and Biologicals.
you will get recurrent uveitis and over time you will develop cataracts, possibly glaucoma and changes to the Macula through Cystoid Macular Edema possible epiretinal membrane formation, VAscularization of the retina etc.
make sure they do a depressed scleral exam on you to see if you have inflammation BEHIND the iris along the PARS PLANA region. this could explain the inability of the opthalmologists to see the initial cells related to iritis. you could have spill over of cells from the pars plana region into the anterior chamber.

make sure you shake the generic corticosteroid bottle for at least THREE MINUTES as it doesn't suspend well and you would not get the proper dose if you don't.

Wish you the very best,
Mike