Iritis with HLA B27 positive

[Binaya]

I am a male.I had my first episode of Iritis(on left eye only) on April 2011 when i was 29.Then,I was diagnosed with HLA B27 positive.I had to use Pred Forte and dialating drops for more that two months.I had my second episode of iritis(on left eye only) on May 2012.I had to use Pred Forte and dialating drops for seven weeks.My doctor said that i may get the iritis again and again. And the only effective treatment is use the drops Prede Forte as soon as i see the symptoms of iritis and see the doctor asap.My question is is there any preventive measure that i can follow to stop the recurrence and prevent it before it gets chronic. What things do i need to take care of to prevent my sight loss in the future? Please recommend any Iritis specialist in sydney as well.

[Mike Bartolatz]

Australia

Peter McCluskey, M.D.
St. Vincent’s Clinic Tel: 9332-6062
Suite 1004 438 Victoria Street FAX: 9332-6063
Darlinghurst, NSW 2010
E-mail: iritis@ozemail.com.au

Lye-Pheng Fong, MD
262 Mountain Way
Nantirna, VIC 3152
Tel: 61-3-259032 Fax: 61-3-9210-7301

Richard Stawell, MD
Cabrini Medical Centre
Isabella Street, Suite 52
Malvern, Australia 3144
Tel: 61 3 9509 4233 Fax: 61 3 9500 9376

Denis Wakefield M.D.
The University of South Wales Tel: 612 938 52351
Professional Suite FAX: 612 93851389
Polyclinic Building
Prince of Wales Hospital
High Street
Randwick 2031
AUSTRALIAE-mail: d.wakefield@unsw.edu.au

Ehud Zamir M.D.
Director of Clinical Training
The Royal Victorian Eye and Ear Hospital
32 Gisborne Street
East Melbourne
Victoria 3002
Locked Bag 8
East Melbourne

Tel 61-3-9929-8533
Swithboard 61-3-9929-8666
Fax 61-3-9663-7203
Email

Recurrent uveitis related to the HLA B27 gene often responds to NSAID therapy, given at prescription strenght. here in the USA Dr C Stephen Foster the top ocular immunologist in the World uses the following NSAIDs. Cellebrex, dIfusinal or Naproxen. it takes about six months before you know if it will work for you. your present one a year bout of uveitis probably wouldn't require this now but if it starts getting more frequent or if your other eye becomes inflammed (HLA B27 uveitis usually ping pongs between eyes) then you should start therapy. I wouldn't self medicate however and I would get routine checks to make sure the middle or back of the eye don't start showing changes or inflammation which you might not know is going on. intermediate uveitis can occur without symptoms as can new blood vessels growing on the retina.

I hope this helps,
mike

[Binaya]

Hi Mike,

Thank you so much for your information. At the moment, i don't have any iritis. So, should i meet one of the iritis specialists(you have recommended) now or in the future when i get next attack(I pray to god not to get iritis anymore).

And the next thing is, is there any precautions i could take to prevent this iritis occurring again?

Thanks,
Binaya

[Mike Bartolatz]

wait untl your next flare up of iritis to see the specialist.
ALWAYS see an ophthalmologist when your eyes start showing signs of renewed inflammation such as red eye, photophobia, blur of vision, increase in floaters, double vision etc. don't just start using steroid eyedrops without a visit. don't ever use expired steroid eyedrops or dilating drops.

the only precaution I can think of is to make sure that you avoid stress if at all possible. if overweight, try to lose some weight, I say this because when fat is excessive around the middle of the body, it causes the adipose tissue to start producing inflammatory cytokines also found in uveitis and other autoimmune disease processes such as diabetes etc. inflammation anywhere in your body can cause renewed inflammation in the eyes. watch for signs of irritable bowel disease and arthritis as they are linked to the HLA B27 gene. proper diagnosis and treatment early on for these things will help keep the eye quiet. if they are active, the eye will be active.

I hope this helps,
Mike

[Binaya]

Thank you so much Mike.I am really very happy that i am getting great guidance from you.

Regards,
Binaya

[Mike Bartolatz]

nothing is too trivial to ask here, sometimes the small things show signs of underlying inflammatory conditions.
GI complaints, Dry eyes, dry mouth etc are also problematic when one has the HLA B27 gene. Psoriaisis and psoriatic arthritis appear as well as reactive arthritis. these symptoms are manageable but ignoring them can lead to problems with the cornea and the sclera with potential for infection and ulceration etc.

Wish you the best,
Mike