Iritis, an introduction

Issues concerning developments in care of Ocular Inflammatory Disease and other noteworthy Items are contained in this forum.

Moderators: Mike Bartolatz, kwork

Ritchie
Posts: 13
Joined: Tue Jul 04, 2006 8:17 pm

Post by Ritchie »

Thanks Mike solid as ever. I understand what you are saying, thank you

Mark
heatherknc
Posts: 4
Joined: Wed Sep 06, 2006 2:58 pm

Thanks for the response!

Post by heatherknc »

Mike,
Thanks for the welcome and the recommendation on the doc. I have had milder attacks of what I am assuming has been the iritis in the past. This one was just finally bad enough to send me to the opthamolgist. I will get further info and diagnoses from him today, and look forward to talking more. I have to admit the diagnosis was scary and I was glad to find you! again, thanks for the welcome!
Heather
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

If you have had numerous bouts of uveitis in the past you should be tested now for the HLA B27 gene. often NSAIDs taken DAILY orally can break the cycle in about 70% of individuals. Celebrex and Dolobid work fantastically to accomplish this IF you cn take them. other meds that work well are Indomethacin SR, Voltaren, Naprosyn and Feldene.

get in to see the specialist too as MOST opthalmoloigists and retina specialists are NOT up to date on this stuff and are not fellowship level trained in the diagnosis and treatment of ocular inflammatory disease processes. that is what a true ocular immunologist does for a living.

Wish you the very best,
Mike
Mike Bartolatz
Moderator
thecatfreak
Posts: 3
Joined: Wed Apr 25, 2007 3:16 pm

vision loss

Post by thecatfreak »

For the last several years, I've gotten iritis once a year. I wish I knew what was causing it, and I would try to prevent it. As long as I get treatment, will I not have any vision loss?
Thank you
Ashley
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

It is impossible for me to say what your final outcome will be. Once one has a history of uveitis, many things can set off a new bout such as allergies or bacteria, viruses etc. even stressful situations can trigger a renewed bout of inflammation. over many years the inflammation and the corticosteroids can sometimes lead to cataracts, glaucoma and other structural changes within the eye. I know of no way to predict who will have these long term consequences of the disease. sometimes, later on the bouts become more difficult to control and at that time the opthalmologist will weigh risks of the disease to use of chemotherapeutic immunomodulatory medications to retrain the immune system to stop attacking your eyes. the only way to find out if this type of therapy would benefit you would to seek an opinion by an Ocular immunologist, a highlytrained opthalmologist with fellowship level training in the diagnosis and treatment of ocular inflammatory disease processes. I could suggest one of these specialists for you if you will tell me where you live. you might have to travel to see one of them.

wish you the very best,
mike
Mike Bartolatz
Moderator
thecatfreak
Posts: 3
Joined: Wed Apr 25, 2007 3:16 pm

vision loss

Post by thecatfreak »

Thank you so much for your help. I live in Frankfort, KY.
Please give me more than one doctor.
thecatfreak
Posts: 3
Joined: Wed Apr 25, 2007 3:16 pm

vision loss

Post by thecatfreak »

Reply to 4/25 reply about supplying immunologists.

Thank you so much for your help. I live in Frankfort, KY.
Please give me more than one doctor.
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Kentucky
Henry J. Kaplan, MD Background Publications Research
Evans Professor of Ophthalmology
Chairman, Department of Ophthalmology & Visual Sciences
Director, Kentucky Lions Eye Center
University of Louisville website
301 E. Muhammad Ali Blvd.
Louisville, KY 40202
Tel: (502)852-3716 Fax: (502)852-4595
E-mail: hank.Kaplan@louisville.edu


above is the ONLY specialist that I am aware of in KY, He is an Ocular Immunologist of very high caliber.

I hope this helps,
Mike
Mike Bartolatz
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mbegun
Posts: 1
Joined: Fri Jul 06, 2007 3:53 pm

First time sufferer...Blurriness subsides?

Post by mbegun »

I was diagnosed with Iritis after seeing an ophthalmologist subsequent to about 12 days of misdiagnosed symptoms. I have had ulcerative colitis for nearly 8 yrs now (28 yr old) and have read a lot about uveitis and its relationship to UC. I have been taking steroid drops aggressively for about one week now and the ophthalmologist says my iritis is hardly noticeable at this point. Subsequently, I have been tapering off the drops. However, my vision continues to suffer in my affected eye. Is this typical? I have an appointment with a specialist in 7 days, but am worried that my vision is more permanently damaged???

Thanks
The Arty One
Posts: 15
Joined: Wed Nov 14, 2007 5:19 am

Advice on second bout of Iritis

Post by The Arty One »

Hello all. I had really bad iritis in both eyes as a teenager, for around 3/4 years. When my both eyes finally were quiet enough to be discharged I was around 16/17. It seems a long time ago- I am 26 now and the exact dates in my mind aren't exact.

Last week I was diagnosed as having Iritis in my left eye, I was sent to eye casualty by my G.P after having cloudy vision. I was appalled at the lack of communication from the doctor who only talked when I asked questions. I guess it was the same last time when I had Iritis too. I worry about the long term implications of all these drops on my eyes. I read somewhere that 850 drops of Pred Forte will result in a cataract, I've estimated that I must have taken around 700 drops already since I was first diagnosed. Or have I come across some misleading info?

I have a review appointment on Monday and if the doctor is rubbish again I may see the specialist in London that people on here have recommended. I guess the impact of my condition is bigger this time as driving is a big part of my life and I don't feel comfortable doing it when my eye is dilated. I am concerned as I haven't had any blood tests from what I can remember to see if I have any other conditions associated with Iritis. As I have my appointment on Monday I need to be really prepared as the doctors will try and send me off with a quick check and prescription like they always do.
Mike Bartolatz
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Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Welcome once again!
the figure of 850 drops is an acurate one. oral and injected steroids can cause cataract and glaucoma as well as the eyedrops.

with your history of uveitis, a referal to a true specialist is warranted and your GP can do that. it doesn't have to come from the eye clinic. sadly bedside manner can be awful without communication with the patient. it is impossible to make 'informed' decisions without communication and that is one of the reason that this site exists today.

you mentioned 'cloudy' vision as your prsenting symptom this time. do you also have inflammation of the Vitreous, perhaps inflammation along the pars plana?
is it from 'flare' or from 'cells' or both?\
flare is protein given off from the cells causing 'cloudiness' or 'smoke like' vision.
cells are 'floaters' moving around inside your vision.

your introduction mentioned Mr William Ayliffe in London, an excellent choice of a TRUE Ocular Immunologist capable ofdoing the tests that you want, interpreting them properly and then teating your disease process/es accordingly using modern steroid sparing treatment.

Please post to in a new post rather than tnis introduciton to uveitis.

Wish you the very best,
Mike
Mike Bartolatz
Moderator
pandabear79
Posts: 1
Joined: Fri Mar 07, 2008 8:30 pm

bilateral uveitis

Post by pandabear79 »

My name is Sandi and my daughter was told that she has bilateral uveitis 13 months ago. She was ten. I guess I am looking for some help. We have been battling this for so long I feel I ahve no where to turn. Not only can they not control this, when they get close she gets shingles in her eyes. We have tried immunesuppressive medications through injections and orally and nothing seems to work. They have done all kinds of blood work and seem to come up with nothing. At one point they claimed that she had something called TINU syndrome which involves the kidneys, but her kidneys do not seem to have any problems??? We have been on pred forte for over a year and that has caused some cataracts, We receive treatment at the Cleveland Clinic, and have been to Johns Hopkins, but still have no answers!!!! Everyone keeps telling me that I have the best doctors? Howver I have become a lot more aggressive in her care lately and I feel that the docotrs hate me now. I just want the cycle to end! Nothing seems to work, the docotors have even presented her case at several conferences and no seems to help. Can anyone help me???
Thank You
Sandi :
Mike Bartolatz
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Post by Mike Bartolatz »

Hi Sandi,
I[m not a doctor but if I were you I'd return to Baltimore and see DR Nguyen at Wilmer. or travel to Boston/cambridge to see C Stephen Foster MD the very best ocular immunologist in the World. if you are in Ohio, there is a doctor in Colombus that is pretty good, Dr Dino Klisovic. I wouldn't recommend anyone else in Ohio bye the way from past member feedback and their need to see one of the doctors mentioned above to finally get proper care
I can provide you contact information if you wish or you can look them up yourself at http://www.uveitis.org in the patient information section of the site on the SPECIALIST list. Dr Nguyen is a very reknown retina specialist AND Ocular Immunologist with many awards of merit as is Dr Foster in Boston/cambridge.
if shingles is causing the uveitis, anti viral medications MUST be used. Valcyclovir would be the drug of choice along with corticosteroids on an ongoing basis to prevent renewed bouts of inflammation from the herpes Zoster virus that causes shingles. the doctors I have mentioned are some of the very best in the World.

there is a support group for parents with kids with uveitis at http://www.uosg.org which is affiliated with DR Foster's Ocular Immunololgy and Uveitis Foundation. we also have a support forum for parents at which one of the moderators at the Foundation site helps out as well .

Please ask any questions you may develop and I'll do my best to help you through this. I'll also contact Renee' and have her respond to you here. I can also move this post to the parent's forum if you would like.

wishing you the very best,
Mike Bartolatz
Mike Bartolatz
Moderator
rtaunton
Posts: 40
Joined: Fri Jul 09, 2004 7:53 pm

Hi Sandi

Post by rtaunton »

I know what it feels like to be fed up, and have the feeling in your gut that the treatment is just not aggressive enough. I back up Mike in his suggestion of doctors that he gave you, it really is key to putting the uveitis in remission.

It does get better. It is a heck of a journey as you are finding out. Do whatever it takes to get the right specialist, and just remember it is an investment in your daughters future. ;)

Let us know how the appt goes. I'll check back in the next few days and see how you are doing.

Hugs,
Renee'
Renee'
Oregon
joblack23
Posts: 6
Joined: Tue Jul 08, 2008 9:32 pm

5 years with iritis

Post by joblack23 »

Just going through my 5th case of iritis in the past 5 years. I guess I can say I am lucky because my first time the doctor identified the problem right away. He put me on pred forte and dialating drops but I could never find out the cause. Recently I did blood test and found to be HLA B27 positive.

I’d like to get to the bottom of this and was hoping you can recommend an optometrist here in Arizona.

Thanks
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