Eye Pain

Post here to exchange iritis general information and support with others.

Moderators: Mike Bartolatz, kwork

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

Re: Eye Pain

Post by Mike Bartolatz »

sorry about your experience, the many shots I've had never hurt but the eyelid did blister up from the fluid deposited there one time under the conjunctiva. I did have pain with my first injection many years ago but the doctor told me to go 'get numb" with schnapps in Germany where I was being treated in a Military Hospital. I don't remember much though ;-).

should pain continue get back in for a pressure check and an slit lamp exam. steroid injections can quickly raise pressure inside the eye as can oral steroids. over time eye drops can as well.

I hope you can get in to see DR Harper in DC soon too.

take care,
mike
Mike Bartolatz
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radlynmendoza
Posts: 13
Joined: Tue Aug 20, 2013 4:29 pm

Re: Eye Pain

Post by radlynmendoza »

Yay! I went in yesterday and I had only 3-5 cells floating around. This from "too many to count" at the beginning of the week. Tapering the Durezol drops to once every two hrs now and the eye pressure was at 16 yesterday. Went to the rheumatologist as well and he prescribed Voltaren for joint pain and wants me to get tested for all the things to approve me for Humira. Not sure I will take the Humira route at this point - we will see how this bout of iritis does. Although I am HLAB27, the joint pain is nothing to write home about. Anyhow, hope the healing continues and will keep updating.
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: Eye Pain

Post by Mike Bartolatz »

uveitis responds better to Remicade but the infusion needs to be at shorter intervals. often 4 to 6 weeks for example.

Humira does help some with uveitis but be forewarned that it may not work. also Enbrel has no use whatsoever for uveitis treatment.

glad your eyes are quieting down. Xray of the spine may not show anything. you might ask for a close section scan of the lower lumbar region to be able to see the beginning stages of Ankylosing spondylitis. AS has been known to start in the shoulders and neck before moving to the lower lumbar region. you could also have Plantar Fasciitis too or swelling of the big toe or index finger indicating psoriatic arthritis especially if the toenail is discolored. GI problems too such as diarrhea related to crohn's and ulcerative colitis.

Take care,
Mike
Mike Bartolatz
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radlynmendoza
Posts: 13
Joined: Tue Aug 20, 2013 4:29 pm

Re: Eye Pain

Post by radlynmendoza »

Thanks Mike, I hope you had a good Labor Day. I had a trace cell today and the doctor has me drastically tapering off the Durezol. Seems so fast from what I've read. She also told me to stop the dilating drops. The problem is I have had to see two different drs. One was definitely more aggressive in treatment than the other. I saw the less aggressive in treatment dr today The eye pressure is still steady at 16. Trying to thread the needle to go see the dr in DC you recommended at the end of the month. Will let you know about that.

I had the kenalog injection last week and found out it lasts 4-6 weeks. I'm still trying to figure out what this means. I guess one of two things can happen - this bout will be gone and stay gone or it will creep back as the injection wears off. Is this how it works? With this 2nd bout of iritis, I have found that I need to stay one step ahead and anticipate so I appreciate your feedback!
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: Eye Pain

Post by Mike Bartolatz »

the Kenalog injection will allow you to taper off the topical steroid quickly. once it is out of your system and the dilating drop is also out of your system, your vision should return to normal. the problem that can sometimes occur is an increase in pressure inside your eye and you can't tell if this is happening in most instances. sometimes the only symptom is a rainbow affect around lights. rarely there is pain. if your peripheral vision starts to decrease get in immediately to the specialist.

I've had many of these shots and they did raise pressure so that I had to start pressure lowering meds. once the injection was gone, the pressure went down.

aggressive care is good in my lay opinion for recurrent or chronic uveitis. hopefully you can get the referral approved for the specialist in DC to care for you.

wish you the best,
mike
Mike Bartolatz
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1elizabeth
Posts: 5
Joined: Mon Sep 02, 2013 10:03 am

Re: Eye Pain

Post by 1elizabeth »

Hi :) I have also had my first steroid injection below my eye this past Thursday. I have been on Durezol drops along with Cyclogyl. ( which cleared up the front of my eye) But I have inflamation in the back of my eye now... My dr. says it takes about 2 weeks to notice any improvements with the injection. Is this accurate?? I am also on all these meds for my R.Arthritis... I guess they aren't working that well because of my eye problem. My pressures are normal and have no Retna detachment thank god... I was wondering what medicines are people using that has helped with clearing up Uvitis? I am on Methotrexate, Prednisone, Embril, and others too... I'm pretty scared. Any info. would be great! Thanks
Mike Bartolatz
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Re: Eye Pain

Post by Mike Bartolatz »

often the dose of Methotrexate has to be increased to about 25 per week and at this dose one usually switches to the injectable form of the drug. the Enbrel will NOT help with uveitis and can even cause it so please ask to be switched to Remicade or Humira for both your arthritis and your uveitis. other drugs can be substituted for the Methotrexate if it is not tolerable or continues to not control the uveitis. the goal is OFF ALL STEROIDS WITHOUT INFLAMMATION Cellcept and Imuran are two drugs that can be used in Lieu of methotrexate.

I hope this helps,
Mike
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1elizabeth
Posts: 5
Joined: Mon Sep 02, 2013 10:03 am

Re: Eye Pain

Post by 1elizabeth »

Thank you so much Mike for all the information. :) I will be talking to my R.A. doctor tomorrow about switching to Humira. I am really excited to use it and hopefully clear my eye up. I just have one question? Would I be using the Cellcept and Imuran together instead of the Methotrexate? Or one or the other? I have never been off of the Mtx for as long as I have had Arthritis ( going on 6 years now.)
Have you heard of any success stories about getting the injection near the eye? I am wondering if it would take care of the Uveitis permanently or like other Cortizone shots, it wears off eventually.

Thanks for answering my questions :D Debbie
radlynmendoza
Posts: 13
Joined: Tue Aug 20, 2013 4:29 pm

Re: Eye Pain

Post by radlynmendoza »

@debbie, uveitis is scary stuff, but you're doing the right thing by being on this site and learning. Although it is sometimes information overload and you can get panicked reading some of it, it is better than the alternative of not knowing anything. I wish you luck in dealing with your uveitis. This is my 2nd bout (the 1st one was over 3 years ago) so I'm having to relearn.

@mike, I went in today and after trace five days ago, I'm back at a +2. More durezol, a milder dilater, And an nsaid drop called potensa which i couldn't find any info on. Maybe I'll get that Voltaren script filled after all. But before I do that, other NSAIDs are mentioned more frequently on the site like Celebrex and naproxen. Should I ask for one of those or does it matter? My rheumatologist is open to suggestions. Seeing DC doc at the end of month.

Also, this bout is presenting itself much more differently than the 1st. I all of a sudden got a severe pain in my temple and then almost threw up on Sunday. I'm not sensitive to light and the eye itself doesn't hurt. Just the pain in the side of my head. Eye pressure was fine yesterday at the doc.

Thanks again for your valuable input.
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: Eye Pain

Post by Mike Bartolatz »

Debbi,
you would take either Cellcept or Imuran as this class of drugs isn't used together.
sometimes a series of cortisone shots to tissue surrounding the eye can stop the process but if it becomes recurrent then it is time to switch to other means. the shot wears off in a couple of weeks or a bit longer depending on the type of steroid used.
but you try to limit their use as all steroids add up over time and can increase the risk of glaucoma or cataract formation. steroids shots run the risk of damaging tissue surrounding the eye or the eye itself as well so this is another reason to limit their use if at all possible. steroids have to be used to calm the beast however so I am not 'anti steroids'. the goal is 'off all steroids without inflammation' if at all possible doing whatever it takes do achieve this.

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

Re: Eye Pain

Post by Mike Bartolatz »

Radlyn,
what was the pressure inside your eyes as the vomiting is often a symptom of glaucoma?
I don't know anything about Potenza and the Acular doesn't work that well for uveitis. Xibrom might (another type of NSAID eyedrop might help.
the Celebrex, dolobid or Naproxen are ORAL NSAIDs taken at prescription strength to replace the steroids .
Dr Harper will be the best person to guide you on this matter. you will require testing to make sure that your kidneys, liver and heart can tolerate various medications before starting anything even OTC NSAIDs

you might ask to be checked for vascular problems with the headache. it could be a migrane as they can also cause vomiting.
migrane meds might be in order ( I take this type of medication)

Glad you are going to her as well. tell her you were sent to her by DR Foster's online support group too.

wishing you quiet eyes,
Mike
Mike Bartolatz
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radlynmendoza
Posts: 13
Joined: Tue Aug 20, 2013 4:29 pm

Re: Eye Pain

Post by radlynmendoza »

Weirdness! I tried to confirm my appointment with Dr. Harper (I had someone else make it for me), and they say there is no Dr. Harper! Can't get in touch with the person who made it for me. I tried to google, but that's the only address that comes up.
Anyway, the pressure in eye was 16 so hopefully not glaucoma! I will look into the migraines. Never had them before, but a first for everything! If you know of any new contact info for Dr. Harper, pls. pass it on. Thanks again!
radlynmendoza
Posts: 13
Joined: Tue Aug 20, 2013 4:29 pm

Re: Eye Pain

Post by radlynmendoza »

Mike, it looks like Dr. Harper is in a place called Fincastle, VA, about 4.5 hrs from me. If this is the same Dr. Harper, she works for Va. Dept. of Health. Any other recommendations. It's a shame that Dr. Nguyen is not in MD anymore.
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Re: Eye Pain

Post by Mike Bartolatz »

Stephanie J. Harper, MD Background | Publications
Howard University Hospital
Department of Ophthalmology
2041 Georgia Ave. NW Suite 2100
Washington, DC 20024
Tel: 202-865-1257 | Fax: 202-865-4259
Mike Bartolatz
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Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Re: Eye Pain

Post by Mike Bartolatz »

would Columbus Ohio be closer to you? Dr Dino Klisovic is there or in NYC, DR Samson, Dr Chu or DR Rosenbaum all trained under DR Foster at Harvard.

mike
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