white cloud im walking around in...

[vinman13]

hey everyone,
I've had hla-b27 iritis since i was 19...now 40...with no AS..it comes every two years in one eye most of the time, sometimes the other....ive seen iritis specialist and people from Will's eye here in philly many times...they said -- no use in doing drops profilactically, you get it every two years-treat it as you have been doing.
Two weeks ago, I got it in both eyes (first time and its freaking me out)...the inflamation is down about 70 percent according to dr but I have this white cloud im waling around in...like a haze different then the blur from the dialation drops....the doctor said some of my pigment was stuck to my lens but he didnt think itd be permanent - have to wait and see when all inflamation is down, etc

My question - anyone experience this and it didn't go away? im sure this has happened when i had it in one eye, but never got freaked out too bad because the other eye saw clear. The other thing is when I use reading glasses up close, or other glasses for far (never had glasses btw - had 20/10 vision my whole life) it clears up the fog...
any help from people would be great.
Victor

[Mike Bartolatz]

it sounds like you either have cataracts forming or perhaps protein in the vitreous called 'flare' present. you may be developing intermediate uveitis as well as the iritis you have experienced in the past. to me it sounds like time to see about a steroid sparing approach to treatment, try some NSAID medications at prescription oral strenght to see if the recurrent nature of this beast can be broken. I have seen MANY people at this site with a long history of HLA B27 related uveitis have renewed inflammation on an annual basis and then after 10 to 20 years it goes crazy and is almost impossible to quiet down with steroids alone. if the NSAIDs don't work, move on to Methotrexate, cellcept or Imuran.

catarcts can cause blur of vison and foggy vision and are frequently the result of uveitis as well as the steroids. Cystoid macular edema formation in the back of the eye can lead to epiretinal membranes which can also cause foggy vision. Only your ophthalmologist can truly tell you why your vision is the way it is by giving you a dilated exam through a slit lamp microscope.

specialist at Wills is at http://www.uveitis.org in the patient information section of the site. Personally I'd go to Baltimore, DC or NYC for care.

wish you the best,
Mike

[vinman13]

thanks for the quick reply, mike...i will look into the NSAID's.

as for cataract...the dr said i have some in my right eye, but i had it before and never noticed it...so if only in one eye, why would it be uniformly blurry and white in both?
secondly he told me the back of my eye and pressure was fine.

here is the weirdest thing....why is the haze and blurriness improved when my eye is dialated? up close is blurry, but I cure that with reading glasses...but the haze and overall visual disturbance is much better when my eye is dialated...when it wheres off it becomes blurry and much more hazy....makes no sense....any ideas?

[Mike Bartolatz]

you might have build up of material on your cornea of the bag the holds the lens called the lens capsule. this can act kinda like a cataract.
I wouldn't worry about it too much but have your ophthalmologist do a pin hole test to see if you see better through the pin holes. that usually indicates that there is build up of protein on the lens capsule from inflammation.

I can provide contact iformatio of a specialist trained by Dr foster in pennsylvania if you like.

he can implement the NSAID therapy and answer your questions.

take care,
mike

[Mike Bartolatz]

Pennsylvania

Raji Shah, MD
Retina Service, Wills Eye Institute
840 Walnut Street, Ste 1020
Philadelphia, PA 19107
Email: rshah1878@gmail.com

[vinman13]

thanks, mike this is who they recomended i see there....he is well trained then?

[Mike Bartolatz]

yes he trained under DR Foster at Harvard. I haven't had feedback yet on him though but he should be able to to get things controlled for you,

wish you the best,
Mike