Uveitis Again

[JHem]

Hello this is the second time in the last 2 years that I have suffered from inflammation in the eye. I currently go to New England Eye Center but soon will be seeing Dr. Papaliodis at Mass Eye and Ear. I can't remember, but this time around I occassionally get cloudy/hazy vision in the affected left eye, has anyone else had this. I also used cyclopentolate hydrochloride and was wondering how long the dialation lasts. I just started pred forte 4 times a day.

[Mike Bartolatz]

I would see DR Foster at MERSI in Cambridge, MA the top ocular immunologist in the World if I were you.
his contact information can be found at http://www.uveitis.org in the PATIENT information section of the site.

each of us responds differently to meds. it can take a day or two to a couple of weeks to get the medication out of your system to where you have no blur. it would be time to check you for underlying cause of the uveitis. if it becomes chronic or if frequency of recurrence becomes more frequent, NSAID therapy might be beneficial in breaking the recurrent nature of iritis in a steroid sparing approach to treatment. frequent steroid use can lead to cataract and glaucoma in some individuals. each bout of iritis increases risk of additional problems occuring with complicatons to the back of the eye for Cystoid macular edema, epiretinal membrane formation, detached retina etc.

wish you the best,
Mike

[JHem]

I had a follow up and there is still a bit of inflammation. I am now on 1 drop of prednisolone every hour and FML ointment at bedtime. I had blood work done and it did come back HLA B27+. I have another appt this friday to check on the inflammation and the next steps with possibly seeing a rhematologist. I still have slightly cloudy/hazy vision if I'm in natural sunlight, though it doesn't hurt at all and the redness has seemed to subside. I do have blurred vision in the affected eye for distance. Is this normal? will it go back to normal? It's really annoying to not be able to read things from far away that I can see out of my good eye.

[Mike Bartolatz]

the blur of vision should go away once off the eyedrops. it can take a week or so to get back to normal. as long as there are no additional changes inside the eye your vision should go back to about where it was before the attack of uveitis. you may see some cells floating around in your vision for some time and you will learn to ignore them. if the floaters increase in numbers, then get in for a checkup right away as they can occur from other things besides uveitis such as bleeding inside the eye. often protein called flare is present in the eye and this can impact how the eye is able to focus because light is dispersed before it reaches the retina. this should go away once inflammation is stopped.

NSAID therapy may be in your future and it works in about 70% of individuals with HLA B27 related uveitis. be aware that this type of uveitis is known to 'ping pong' between eyes. you get one eye quiet and then the otehr eye can become inflammed.

hope this helps,
Mike

[JHem]

Back at it again....though when I went in yesterday they said i was only about a .5 to 1 on their scale. Same left eye is a little red on the outer part of the eye and there has been a bit of discomfort/tenderness. Not really sure why there is pain (not severe) in the eye if there isn't all that much inflamation (when i was in last week they said they didn't see any inflammation, but it still hurt). I'm on 4 drops pred per day and they just had me start today on naproxen 375mg twice a day. I just really want the discomfort to go away.

[Mike Bartolatz]

pain on the exterior of the eye is linked to Scleritis and it has a red eye associated with it. it is a separate disease process from uveitis in MOST cases (rarely occurs and called sclerouveitis) sometimes linked to autoimmune conditions. episcleritis causes a mildly red eye that does not cause pain.
if the red eye is linked to uveitis/iritis it isn't painful but it can also have dry eyes associated with it causing a gritty sensation like sand in your eyes.

it is time to see an expert Ocular Immunologist. Please see DR Foster.

wish you the very best,
Mike