Iritis, Synechia and cataract surgery.

eyeballsofflesh · Post by **eyeballsofflesh** » Wed Jul 11, 2007 12:59 pm

I've been dealing with chronic bilateral iritis for well over 6 years now and, as a result, (I hope Iâ€™m saying this correctly) have synechia in my right eye. The wonderful team of doctors over at the JHU Wilmer Eye Institute have tried repeatedly and relentlessly to unstick it with dilating drops, but it hasnâ€™t worked so I guess Iâ€™m stuck with it... for now? No pun intended. So Iâ€™ve been off and on oral steroids, had numerous injections and have been through enough bottles of prednisolone to fill a lake. As if having iritis in the first place wasn't fun enough, the latter treatment has caused me to develop cataract in both eyes. YAY!

It is getting to the point where the cataract is noticeably affecting my vision. Of course my eye doctor and I have been discussing cataract surgery because of it. Anyway, the last time I saw him was in the beginning of June and he said I was â€œstableâ€, that the clock is now being watched and that I can have the surgery provided I remain stable for the next three months.

I'm already kind of freaking out about the surgery as it is because I'm probably going to be awake and someone is going to be digging around in my eyeball as I watch because I have no other choice. You'd think that I'd be used to it by now. Nuh uh. Now, I donâ€™t know how or why it escaped my mind to ask my doctor, but, uh, considering the nature of cataract surgery, how does it work when the iris of your eye is stuck to the cataract laden lens that is in need of being removed?

Mike Bartolatz · Post by **Mike Bartolatz** » Wed Jul 11, 2007 7:29 pm

This is the way the adhesion is broken from iritis. sometimes they have to take a small V shaped section of the iris out to get the lens out but in most instances this isn't needed.
if your eye is quiet for three months, the surgeon will usually give addional corticosteroids and antibiotics prior to the surgery just to make sure you don't flare up. Mine did and it was a battle to get them quiet once again. Has anyone suggested a steroid sparing approach to treatment for you such as NSAID or DMARD drugs used to treat arthritis in an attempt to stop this viscious cycle of long term uveitis and steroid alone treatment?

Wish you the best,
Mike

eyeballsofflesh · Post by **eyeballsofflesh** » Thu Jul 12, 2007 7:42 am

Thank you very much! That makes me feel much better about the whole thing. I'm also glad that I probably won't always have this little goat/alien eye.

None of my doctors, and I've had several "specialists", has ever mentioned any other kind of treatment. Not to my recollection anyway. I'll be bringing it up on my next visit though.

Mike Bartolatz · Post by **Mike Bartolatz** » Thu Jul 12, 2007 2:32 pm

http://www.uveitis.org/medical/treatment/algo1.html

above is a link to the means of getting you off all steroids and perhpas to Remission from recurrent uveitis.

Wish you the very best,
Mike

eyeballsofflesh · Post by **eyeballsofflesh** » Fri Jul 13, 2007 7:58 am

Again, thank you very much. You've been most helpful.

Mike Bartolatz · Post by **Mike Bartolatz** » Fri Jul 13, 2007 8:34 pm

you mignt consider contacting DR Nguyen there in Blatimore. he is an ocular immunologist and can implement a steroid sparing approach to treatment for you if it is called for.
contact information can be found at http://www.uveitis.org in the specialist list at the PATIENT information section of the site.

Wish you some quiet eyes,
Mike