Can Prednisolone drops cause damage if no flare up?

[meikog]

I have early symptoms of a flare up. Head ache behind my right eye (flare up is always in my right eyey, never my left). And a little bit of watery eye last night. The redness hasn't shown up, yet. Since it is Sunday I'm not able to call my dr. I was wondering if I start using the drops and I am not actually having a flare up, can that cause damage to my eye? Although I'm pretty sure it is a flare up. I've had a stressful week and went off the TNF in December, trying to get pregnant and do not want to be taking any medication.

[Mike Bartolatz]

it takes about 850 drops of 1% prednisilone acetate for cataracts to start to form in SOME people (about 50%). steroids are the first line of defense with uveitis and have to be used during a flare up. call your doctor for advice. unless you have problems with elevated pressure from the steroids, they shouldn't be a problem during pregnancy. only oral steroids would be of concern from what I've been told. often the first trimester of pregnancy can bring on new inflammation. by the third trimester the womans body makes a substance that controls inflammation. after birth of the child, this substance is no longer made so another bout of inflammation can occur which can be difficult to control. to help keep systemic effects of the steroid to a minimum, put the drop in the eye, then with your eyes closed and head tilted back, press in on the inside corner of the eye to 'occlude the punctum' the drain for the eye. hold this for about a minute so the drop will be absorbed by the eye and will not go down the sinuses in to the throat causing the terrible aftertaste.

wish you the very best,
Mike

[meikog]

Thank you Mike! I have had at least 8 flare ups over the last 5 years. No one has ever told me about pressing in on the inside corner of the eye. I will try that. This board has been a great help since I was first diagnosed with Iritis in '05. Since then I have tested positive for HLAB27, and was misdiagnosed with Anklosing Spondilitis. I was taking enbrel until December of last year, which helped with the arthritis, but not so much with the Iritis, so I stopped taking it all together. Now when I get a flare up I start the drops right away and get an injection in my eye. Still not sure that I am even having a flare up now. So I will call my dr. today and get in to see him. Thank you again!

[Mike Bartolatz]

press your doctor for immunomoduation. Enbrel is useless for treatment of uveitis but other TNF A drugs such as Remicade or Humira are very helpful but them MUST be used in conjunction with a DMARD drug such as Methotrexate, Celllcept, Imuran etc in order to get to REMISSION, not just management of the uveitis. over time you will develop complications if you remain on just corticosteroids. the maximum number of injections is about 6 before these begin. oral steroids can present systemic complications as well as cataract, glaucoma, bone density loss with potential necrosis too. Please try to make an appointment with a REAL expert in treatment of uveitis. can you tell me where you live so that I can suggest an ocular immunologist for consultation? I'm very concerned about you.

wishing you the very best,
mike Bartolatz