Update on My chronic iritis, HLAB27 etc.

[viashvan]

Late response here! So I've been weaned down on the drops, but my inflammation keeps coming back with a vengeance. No strabimus (I think it's called) since October 2011. Now I'm back up to 4x Prednisolone drops & 3x a day dilating. My eye pressure last week was in the early 20's, but as you all may know eye pressure can dramatically fluctuate. If I reach a point of steroid induced glaucoma my ophthalmologist will prescribe another drop.
Of course I've been tested for so many things now I'm not for certain how many conditions have been ruled out. My iritis is definitely chronic however. Sometime when I'm weaned back down on the drops I start experiencing a light pain/mild discomfort in my left eye, but again, I'm unsure what would cause that. Can my eye be addicted to steroid drops? lol.
So I've gotten a Rheumatologist, Dr. Hadler of UNC Chapel Hill Spine Center I believe it's called. He also sent me to a UNC Opthamologist who offered no new discoveries, which in a way may be a good thing.
On top of the the previous bloodwork, MRI, & back/pelvic xray, Dr. Hadler sent me for a neck xray & more blood work (looking for rheumatoid factor).
Everything came back as negative.
I am due to see Dr. Hadler again in May, and from what I understand (of his overview that he wrote up to send to the other doctors), he plans to make an informed decision using my family physician, my local ophthalmologist, the UNC ophthalmologist, and his own notes/exam findings to make a plan for the next steps.
I've heard the name Methotrexate thrown around a lot. I've also been told that many times doctors just can't pinpoint down what causes the iritis, and it can come and go. Of course mine is pretty consistent, but I'm managing the best I can. Trying not to get frustrated, pray a misalignment never happens again, and appreciative that I have so many doctors willing to be serious thought and effort into my case.
I wish you all the best as well!
I've started the following blog as well regarding my eye journey: http://victoriouseyes.blogspot.com/2012 ... -eyes.html

Victoria

[Mike Bartolatz]

Victoria,
are you HLA B27 positive? I can't tell by your post. if you are, an NSAID might work to break the chronic cycle of this. Celebrex, Dolobid or Naproxen can often calm things down so that you can taper off the steroid eyedrops.
if not the next step on a stepladder approach to treatment would be the addition of Methotrexate or other DMARD drug so that you can slowly taper off the corticosteroid eyedrops. you have to get off of them as soon as possible before pressure inside your eyes starts to slowly take out your peripheral vision (this happened to me BTW). it can take about six months of MTX therapy before you will know for sure if it will work for you. during this period of time the doctors will keep uping the dose until you can taper off the steroids until you are off all steroid without inflammation. then you have to stay on the drug for TWO YEARS before taper off of it so that your immune system can learn to stop making the white blood cells that are mistakenly attacking your eyes.

DR Glenn Jaffe is the Ocular Immunologist at Duke that can help you through this,

wish you quiet eyes,
Mike