Seeing a Specialist

Find an iritis/uveitis doctor close to you.

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CaliGirl
Posts: 9
Joined: Sun Jul 31, 2011 2:11 am

Seeing a Specialist

Post by CaliGirl »

At what point do people move from an opthamologist to seeing a specialist? My opthamologist knew immediately that I had iritis and, when I had another flare-up just two months after finishing treatment, ran all kinds of bloodwork. All of the tests have come back negative so we don't know why I have iritis. If I have another flare-up, should I be consulting with a specialist???
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: Seeing a Specialist

Post by Mike Bartolatz »

is the uveitis in one eye or does it go back and forth between eyes?

if in one eye, is there a lot of adhesion between the iris and lens and is the pressure in the eye high? if yes, do you have cold sores? if yes it could be that you have herpes Simplex virus uveitis.

if you are a young woman and have a history of kidney infections, have the doctor test you for TINU.

did he test you for the HLA B27 gene?

do any of your immediate family members have an autoimmune disease, autoinflammatory disease? you live in California: have you ever been exposed to the mold that causes 'valley fever? have you ever had Lyme disease? do you have a cat or dog? if yes, have you been tested for Toxocara infection? checked for catscratch disease?

if your iritis continues to return, then yes you might consider a corticosteroid sparing approach to treatment. if all pathogens have been ruled out, the NSAID therapy with prescription strength drugs like Celebrex, Difusinal or Naprosyn could be tried for six months to see if they could get you to "off all steroids without inflammation'. then you would stay on the nsaid for TWO YEARS in order to get your immune system to stop attacking your eyes.

I hope this helps,
mike
Mike Bartolatz
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CaliGirl
Posts: 9
Joined: Sun Jul 31, 2011 2:11 am

Re: Seeing a Specialist

Post by CaliGirl »

Thanks Mike ~ your response was very helpful! At this point the uveitis is only in one eye and I've only had adhesion one out of the two flare-ups so far. My doctor did do the HLA-B27 test but it was negative. I do have a cat so I should probably get tested for the Toxocara that you mentioned. My eye pressure so far has been okay so I'm guessing the doctor will send me to a specialist if that changes or if they figure out what's actually causing the uveitis. It's interesting that you mentioned Naprosyn as I was already taking that for inflamation in my wrists (carpul tunnel) and my back when I had my first flare-up. My doctor mentioned possibly getting x-rays of my lower back (some connection between that and the uveitis?) so I think that's my next move.

This is all very new to me so I truly appreciate your advise!

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

Re: Seeing a Specialist

Post by Mike Bartolatz »

often ankylosing spondylitis is involved in low back arthritis. usually when AS is present along with uveitis the HLA B27 gene is present. other genes can also cause AS. the IL23R, ERAP1 and IL1R2 genes can be linked to AS as well and they can also cause other conditions sometimes found which can have uveitis as a component or the immune system response.
cat scratch disease can be spread by a cat's saliva so no scratch is required FYI. we had a lady get catscratch uveitis this way. the saliva got into her eye.
get the cat tested for this too.


wishing you quiet eyes,
mike
Mike Bartolatz
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