eye floaters

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miamimom
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Joined: Sat May 05, 2007 9:05 pm

eye floaters

Post by miamimom »

Could floaters in a child's field of vision be a sign/symptom of iritis?

My son has never experienced iritis, but he is monitored for it due to his juvenile spondyloarthropathy. He is HLA-B27 positive. Over the past several days (less then a week) he has been talking more and more about "spots" that he has been seeing that sound like floaters. Yesterday morning he was mildly (but enough to notice) light sensitive which made me start to wonder about the floaters. After school, the floaters were "gone". He did tell me that he often has the floaters, but that recently there are more of them and they are more frequent.

I googled "floaters" and "pediatric opthomology" and it came up with several references for iritis. His eyes are not red and he is not significantly light sensative the way my brother is when he experiences iritis. Are floaters common and benign in kids the way they are in some adults? Am I worrying needlessly?
Mike Bartolatz
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Post by Mike Bartolatz »

only an opthalmologist through the slit lamp examination can determine if your child has iritis or other forms of uveitis. aversion to light and floaters along with a red are symptoms of uveitis. although a couple of floaters aren't anything unusual in a child without severe near sightedness, they are of concern if they increase and are evident when not looking down and should be a sign that your child should have an exam right away especially since your other child also has uveitis. although one can have Ankylosing spondylitis and not have uveitis, his current situation should signal the need for at a minimum annual opthalmoogical exams.
sometiimes the area just behind the iris become inflammed with Ankylosing spondylitis and the eye won't become 'red' as with iritis. the cells are in the vitreous causing the floaters. there is also exudate along the pars plana, the innermost part of the ciliary body which produces the fluid inside the eye and which also controls the iris. the cells exudate along the pars plana can cause what is known as Vitritis, inflammation of the front part of the vitreous humor which contains the jelly like substance that fills the eye cavity.
uveitis in children can be quite severe and can also quickly progress to additional changes within the eye. for this reason, we suggest that any child with uveitis be under the care of a very specialized opthalmologist, an uveitis specialist also known as an Ocular immunologist. Uveitis related to Ankylosing spondlyitis often responds well to Non steroidal anti inflammatory medications. steroids are used to quell the initial inflammation and then the NSAID is used to keep the systemic inflammatory processes quiet thus keeping the uveitis quiet as well. if NSAIDs fail then other drugs known as DMARD or Disease Modifying Anti Rheumatic drugs are used. these include Methotrexate, Cellcept, etc and sometimes one of the biological drugs such as Remicade or Humira are also combined to stop the disease processes.
please contact your pediatric opthalmologist for an appointment and full exam.

if you don't already see one of the specialists at Bascom Palmer, DR Janet Davis or Dr Perez are very good. Dr Perez is especially good with kids.

wishing you and your children the very best,
Mike Bartolatz
Mike Bartolatz
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rtaunton
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Joined: Fri Jul 09, 2004 7:53 pm

Hi Miami Mom

Post by rtaunton »

Sounds like more than just iritis to me, too. My daughter used to name her floaters. I would be driving down the road, and my then 6 year old would say, They're baaaaaaaaack! lol

You are lucky to have two true specialists to choose from. If I missed it, I'm sorry, but how old is your child?
Renee'
Oregon
miamimom
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Joined: Sat May 05, 2007 9:05 pm

Post by miamimom »

I went ahead and made an appointment for him. He will be seen in the morning.

My son is 12. He has juvenile spondyloarthropathy. He has never had iritis before, but we are well aware of the risk with spondys. His eyes are re-evaluated every 6 months - they were fine in August. (I know that doesn't mean they are fine now.) He has been on NSAIDs for quite a while. Interestingly, his joint symptoms have also worsened over the past week. I hope this does not signal an overall increase in spondylitis activity.

Thanks for your help!
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

i hope that he doesn't have additional activity with the A.S. playing it safe is the way to go. I also pray he doesn't have iritis or other form of uveitis. you may wish to get a consult with either Dr Perez or Dr Janet Davis at Bascom Palmer if uveitis does become a part of his future. their contact information can be found at http://www.uveitis.org in the PATIENT information section of the site. click on SPECIALIST list on the left side of the page and then select US specialist list within Florida.

Keep us informed one way or the other. We're here to help if we can. YOU ARE NOT ALONE.

wish you and your child the very best,
mike
Mike Bartolatz
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miamimom
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Joined: Sat May 05, 2007 9:05 pm

Post by miamimom »

It is iritis after all. I had my doubts because he was not complaining of pain. In fact, I almost canceled the appointment.

Thanks for your help and the push to have him examined. We are fortunate to live close to the University of Miami and some excellent doctors.
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Please see DR Perez or janet Davis at Bascom Palmer, they are not just opthalmologists, they are OCULAR IMMUNOLOGISTS, Dr Perez did fellowship level training at Harvard and MEEI in Boston under Dr Foster the top ocular immunologist in the World.
they are better than 'good doctors at the university of miami' too they are top notch.

some of us have pain and photophobia, others don't. usually this indicates more ciliary body involvement or posterior uveitis going on which can occur with Ankylosing spondylitis rather than an iritis alone situation.

wish you the best,
Mike
Last edited by Mike Bartolatz on Mon Sep 29, 2008 9:54 am, edited 1 time in total.
Mike Bartolatz
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miamimom
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Joined: Sat May 05, 2007 9:05 pm

Post by miamimom »

Thanks Mike. He is in excellent hands.

"Bascom Palmer Eye Institute, which serves as the Department of Ophthalmology for the University of Miami Miller School of Medicine in Miami, Florida, is recognized as one of the world's finest and most progressive centers for ophthalmic care, research and education."

"For the fifth year in a row, the University of Miami Miller School of Medicine’s Bascom Palmer Eye Institute has been ranked the nation’s best in ophthalmology in U.S. News & World Report’s annual Best Hospitals survey. "
Mike Bartolatz
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Post by Mike Bartolatz »

Both doctors that I mentioned are with Bascom Palmer. you are very fortunate to be able to have true ocular immunologists available to you through this institution. there are only about 100 of these highly trained specialists available in the USA with most of them located in the Northeast of the USA and spread very thinly in a few other states. most of us have to travel hundreds of miles to see one of them. my state only recently (9 months ago) got one of them.

I hope your childs uveitis can be controlled quickly. often an NSAID such as celebrex can be added to stop the systemic inflammation thus controlling the uveitis and getting him off of the corticosteroids early on before they can cause cataracts to develop or intra ocular pressures go up.

wishing you the very best,
Mike
Mike Bartolatz
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