A trigger for Iritis

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A trigger for Iritis

Post by IanB » Sat Apr 19, 2014 7:35 pm

Good Morning
I would like to know more about the triggers, because my Iritis always had something to set it off.
The first time I was kicked in my left eye, It took a very long time to cure as only putting drops 5 times a day only held it at bay for a week then an injection in the eye was required to stop the degeneration of the eye, It was stopped over a period of 3 months.( 18 years old Christchurch, New Zealand)
The second time I was 38 years old and I was hit in the left eye with a piece of metal at work, This time it took six months to control and stop. ( Perth, Western Australia)
The third time, I am now 54 years old, It started as a irritation in the left eye but I knew what the problem was and how to cure it so three months and stopped.
The forth time, I am still 54 years old and 6 weeks later, Dirty water from the front wheel of my bicycle.
Now I have a cataract witch was formed almost instantly from a bump on the head above my left eye. I now have a problem as I can clear the Iritis in 10 weeks but keeps coming back after 2 weeks for no reason, This has been going on for a year as this bump happened in April 2013. I do go to the eye clinic as I do have the auto immune problem in my blood.
I asked the Doctor at the eye clinic if the cataract could be causing the problem, The answer is no because it is inside the lens and from a different part of the eye.
I would like to know if the cataract could cause the immune system to think there is a problem with the eye and be trying to fix it and this is causing the Iritis to return as I can see no other reason.
I have had Xrays and blood tests and everything else is fine.

Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: A trigger for Iritis

Post by Mike Bartolatz » Mon Apr 21, 2014 12:29 pm

actually a type of cataract called a subcapsular cataract which is small and very dense is frequently found in uveitis patients. this can mature with use of corticosteroids of any type. usually surgery is NOT done until the eye is quiet for at least three months because of risk from the trauma from surgery to the eye to cause additional uveitis to occur. trauma is frequently causes uveitis. triggers can be from allergy, or even an infection anywhere in your body. recurrent uveitis such as that which you now have is often treated with a corticosteroid sparing approach to treatment. this means that steroids are used to put out the 'fire' of inflammation and then other drugs are employed to keep the eye quiet. steroids over time CAUSE cataracts and in some individuals they can also cause glaucoma to occur. it is important to always see an ophthalmologist each time one gets new inflammation to watch for this. even without steroid use the inflammatory cells can block the drains for the eye resulting in Glaucoma. pressure checks ever couple of weeks are needed to watch for this when one has active inflammation or while on steroids.

it might be time to recheck you for systemic causes of uveitis. for some individuals it can take a decade or more before serum markers appear. forms of arthritis are frequently the culprit as are skin rashes, GI problems etc.
pathogens can also cause uveitis to occur. one cannot assume that just because one has a history of uveitis that the renewed inflammation is linked to the previous cause. exposure to gut bacteria that cause diarrhea for example can trigger autoimmune conditions. so can sexually transmitted Disease, malaria, TB, etc. there are over 90 different things linked to uveitis.

If pathogens are ruled out, then one can used something as simple as a Non steroidal anti inflammatory medication such as Celebrex, Dolobid or Naproxen to see if this will keep the eye quiet. one would stay on the drug for TWO YEARS at prescription strength to allow the immune system to stop making the inflammatory cells that keep the uveitis going on inside the eye. if this doesn't work then DMARD Drugs such as Methotrexate, Cellcept or Imuran are used. the recurrent nature of your uveitis can lead to structural changes in the retina such as cystoid macular edema, fluid build up under the retina that can potentially cause detached retina to occur. other changes can also occur with a scab growing over the site of the CME ( Cystoid macular Oedema in the UK, NZ an Australia and Canada)

I hope this helps,
Mike Bartolatz

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