Chronic Iritis

[CaliGirl]

Hi! I was diagnosed with Iritis about a year-and-a-half ago. I've had all kinds of tests to see if I have an underlying cause to my iritis but so far the doctors haven't found anything. When I have a flare-up, I'm usually on prednisone drops for about a month. Within 2 months after that, I have another flare-up. In an effort to stop the repeated flare-ups, my opthamologist put me on the drops for two months weening me off very slowly. Unfortunately, that didn't work and even though I was on the drops every other day, I still had another flare-up. Fortunately, my flare-ups are painful but not considered severe. Even though it isn't a high dosage, I'm nervous about being on prednisone for such a long period of time (going on 4 months now). Are there any other medications out there that won't be as harmful to my body or anything that might stop the frequency of my flare-ups???

[Mike Bartolatz]

yes but they have to be treated by your doctor and montiored.
I do have a couple of questions, are you young and do you have a history of urinary tract infections and have bilateral uveitis?
sometimes tuberointestial nephritis and uveitis syndrome is the underlying cause in young women.
if not, then a trial of NSAID such as celebrex, dolobid or naprosyn can frequently stop the recurrent nature of this stuff. it is taken at prescription strenght for about 6 months at prescription strength and you are tapered to off all steroids without inflammation.
if that doesn't work then the DMARD drug methotrexate is used or Cellcept or Imuran.
do you have a specialist ophthalmologist called an ocular Immunologist treating you now? DR Ira Wong is in San Francisco, DR Levinson is at UCLA and Dr Rao is at Doheney Eye intitute in LA. their contact information can be found at http://www.uveitis.org in the patient information section of the site.

sadly I know of no means of treating autoimmune related iritis than the above. if a virus or other pathogen is the cause then that would require other drugs to treat.
if your iritis is in one eye only, do you have a history of cold sores? this is can be linked to iritis and then antiviral meds are used.
another thing in California that causes uveitis is Valley Fever so if you have been exposed to this mold, it could be the cause.

pets can also carry things that cause uveitis too.

wish you the best,
mike

[CaliGirl]

Thanks for your suggestions Mike! In answer to your questions, I'm 48 years old (I guess that doesn't qualify as "young" ), don't have a history of bladder infections, and I only have iritis in my right eye. Although all of my tests have come back negative, my ophthalmologist has been wondering if there is some kind of connection to my chronic tendonitis ~ which is also only on the right side of my body. I've taken naprosyn for my tendonitis before which helped with my tendonitis so I'll talk to my doctor about going back on that for a longer period of time. I'm a Kaiser patient and my ophthalmologist hasn't sent me to the specialist associated with Kaiser because he says my case isn't severe enough ~ I don't know if she's an ocular immunologist or not. I agree that my flare-ups aren't as severe as some I've read about on this site, but I can't imagine being on prednisonal for extended periods of time can be good for me either!

I appreciate all of your suggestions and will look into seeing an ocular immunologist too!

Thanks!
Sara

[Mike Bartolatz]

sara,
recurrent iritis does damage to the eye and steroids build up causing glaucoma and cataracts to form so be very watchful of your intra ocular pressures as you get steroid only treatment. write down the pressure reading and if it goes up a little bit every time you go in (under 24 is normal) but if you are at 15 for the first appointment and 18 the next and 21 the next you are probably a steroid responder and if it gets much higher and stays there it might one day go into the 30's or more which would require pressure lowering drops. sometimes one sees rainbows around lights and this is a symptom of glaucoma. glaucoma can have NO symptoms and all of a sudden one loses peripheral vision.
( this happened to me)
push to see a specialist. hopefully they will have someone that knows about this and will treat you with a steroid sparing approach to treatment. Celebrex, dolobid and naproxen are the NSAIDs that Dr Foster uses at the Ocular Immunology and uveitis foundation.

you may need to see an ombundsman within Kaiser to get to a specialist.

wish you the best,
Mike

[CaliGirl]

Wow! Good to know! Thank Mike ~ I'm pushing for the specialist!

Sara