I've had recurrent Iritis for the past 7 years...but I've noticed that since last year the episodes have increased. Last year I had five flare ups...This year I've already had two. I've had about 6 different blood test done and all come back negative.
1. ANA
2. HLA B27
3. ACE
4. Lysozyme
5. RF
6. FTA-ABS
Is this always the case with Iritis or should my opthamologist be looking into it more?
Luz
recurrent Iritis
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Mike Bartolatz
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Re: recurrent Iritis
how soon does the iritis return once off the steroid eyedrops?
the ANA should be repeated from time to time especially if you start having any signs of arthritis, rashes, breathing concerns, neuropathy, Gastrointestinal discomfort etc,
does anyone in your family have a systemic disease?
have you been around cats or dogs where round worm has been present as toxocara can cause this. another thing is LYME disease.
is your iritis granulomatous?
ANA is related to many autoimmune diseases but it can take a decade or more before blood tests reveal the underlying disease in some instances and is why the test is repeated, the FTA ABS is for sexually transmitted disease processes. HLA B27 links uveitis as well as seronegative spondyloarthropathies and enteropathic arthropathies. you can still come down with them and be HLA B27 negative in about 30% of cases. ACE and Lysozyme are for POSSIBLE sarcoidosis but they are not specific for sarc yet are about the only blood test available if sarcoidosis is suspect so this would indicate that you have granulomatous uveitis present. if you have severe dry eyes and dry mouth, a lip biopsy can be taken to rule out Sarcoidosis or Sjogren's syndrome. are you rheumatoid factor negative, RF - it lessens the likelihood of sarcoidosis and other connective tissue disease processes are the culprit. did they test you for Tuberculosis? (rare cause but possible).
is this in only one eye and if yes did you develop elevated pressure along with an iris that doesn't open and close? herpes Sx
did they test you for hepatitis (also a rare cause).
if you traveled to a place with Malaria, did you contract it?
did you first bout come after a bout of GI tract problems, stomach pain, vomitting and diarrhea? Enterovirus, bacterial infections etc
did you hike in the woods where racoons are present? Giardia (fecal matter contaminates hands or water is injested from a stream, lake etc that is positive for this also known as 'Beaver fever'.
how old were you at onset and if a female,(teens to twenties but can be older) did you have a history of urinary tract infection with bilateral uveitis? TINU. rarely found in males
just some thoughts. you might benefit from getting an ocular immunologist involved as they are aware of the more than 85 different causes of uveitis. they can implement a corticsteroid sparing approach to treatment as you are having inflammation way too often and it will lead to damage to the inside of your eyes if this continues. usually Cataracts are the first complication that are not easy to keepthe eye quiet as this is Trauma which causes renewed inflammation. Glaucoma can occur too and before you know it you have lost significant vision as usually there are no symptoms until halo's appear around lights or you have lost peripheral or central vison. some people develop Cystoid macular edema, fluid forms a pocket below the retina detaching the retina and the rods and cones die, causes areas of blindness or distortion of vision. Retinal vascularization causes bleeding and detachment of the retina.
I'm not trying to scare you but to indicate how serious it is to just 'wait and see' or inform you that it could be a very long time before this 'burn's out' which can be after signficant and permanent vision loss (me).
where do you live so I can suggest and expert in this, an Ocular immunologist. I prefer to tell people the BEST specialist closest to them as not all doctors are created equal in my lay opinion. this goes for the specialist list at http://www.uveitis.org in the PATIENT information section of the site.
wish you the best,
mike Bartolatz
the ANA should be repeated from time to time especially if you start having any signs of arthritis, rashes, breathing concerns, neuropathy, Gastrointestinal discomfort etc,
does anyone in your family have a systemic disease?
have you been around cats or dogs where round worm has been present as toxocara can cause this. another thing is LYME disease.
is your iritis granulomatous?
ANA is related to many autoimmune diseases but it can take a decade or more before blood tests reveal the underlying disease in some instances and is why the test is repeated, the FTA ABS is for sexually transmitted disease processes. HLA B27 links uveitis as well as seronegative spondyloarthropathies and enteropathic arthropathies. you can still come down with them and be HLA B27 negative in about 30% of cases. ACE and Lysozyme are for POSSIBLE sarcoidosis but they are not specific for sarc yet are about the only blood test available if sarcoidosis is suspect so this would indicate that you have granulomatous uveitis present. if you have severe dry eyes and dry mouth, a lip biopsy can be taken to rule out Sarcoidosis or Sjogren's syndrome. are you rheumatoid factor negative, RF - it lessens the likelihood of sarcoidosis and other connective tissue disease processes are the culprit. did they test you for Tuberculosis? (rare cause but possible).
is this in only one eye and if yes did you develop elevated pressure along with an iris that doesn't open and close? herpes Sx
did they test you for hepatitis (also a rare cause).
if you traveled to a place with Malaria, did you contract it?
did you first bout come after a bout of GI tract problems, stomach pain, vomitting and diarrhea? Enterovirus, bacterial infections etc
did you hike in the woods where racoons are present? Giardia (fecal matter contaminates hands or water is injested from a stream, lake etc that is positive for this also known as 'Beaver fever'.
how old were you at onset and if a female,(teens to twenties but can be older) did you have a history of urinary tract infection with bilateral uveitis? TINU. rarely found in males
just some thoughts. you might benefit from getting an ocular immunologist involved as they are aware of the more than 85 different causes of uveitis. they can implement a corticsteroid sparing approach to treatment as you are having inflammation way too often and it will lead to damage to the inside of your eyes if this continues. usually Cataracts are the first complication that are not easy to keepthe eye quiet as this is Trauma which causes renewed inflammation. Glaucoma can occur too and before you know it you have lost significant vision as usually there are no symptoms until halo's appear around lights or you have lost peripheral or central vison. some people develop Cystoid macular edema, fluid forms a pocket below the retina detaching the retina and the rods and cones die, causes areas of blindness or distortion of vision. Retinal vascularization causes bleeding and detachment of the retina.
I'm not trying to scare you but to indicate how serious it is to just 'wait and see' or inform you that it could be a very long time before this 'burn's out' which can be after signficant and permanent vision loss (me).
where do you live so I can suggest and expert in this, an Ocular immunologist. I prefer to tell people the BEST specialist closest to them as not all doctors are created equal in my lay opinion. this goes for the specialist list at http://www.uveitis.org in the PATIENT information section of the site.
wish you the best,
mike Bartolatz
Mike Bartolatz
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