I have questions regarding impressions I got with Dr. Foster. I would have asked him, but it took awhile to really grasp everything. I understand the treatment (Cellcept and Celebrex 2xs a day), but have questions that I thought of after my visit. It's not ideal but we are moving and he advised me to wait on treatment until I get settled so no one drops the ball.
Here is the info on the Impressions and plans:
I have HLA B27 associated chronic anterior Uveitis OU. (That I know) Recent flare with viritis and capillititis OD and uveitis is better OD with PF every 2 hours. Has persistent viritis OD doing FA mac ODT. Upped Celebrex from 1 to 2xs a day. Weane off PF one drop a week. FA shows diffuse vitreos haze but cannot see vasculitis other than questionable capilliritis and capaillary pruning with larger FAZ OD. OCT shows perifoveal edema. Cellcept 1gm bid empty stomach.
I was told that the iritis is clearing (was a 2.5+ and now clearing) but I have vitreous cells of 1.5+. My vision in my right eye is hazy, with tiny black dot floaters and larger strand floaters that move around and often make is difficult for me to read/focus. Are these permanent or will they calm down/go away when the inflammation goes down?
Can you explain what all of this means? Do I have to be watching for anything that would constitute and emergency sight wise? I have always gotten Iritis, so I feel unsure if this is normal for the back of the eye. It is very annoying to say the least. I understand this to be posterior Uveitis correct? Shouldn't I be doing something (like oral steroids or infusion) to treat it. It could be months before I get a doctor who will treat me with Cellcept. I know Pred Forte doesn't touch it, so does it just brew until then? I am very concerned that I might lose vision. Dr. Foster didn't ask to see me again and I told him I don't move for another month.
Thank you,
Jennifer
Pruning
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Mike Bartolatz
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Re: Pruning
"
I was told that the iritis is clearing (was a 2.5+ and now clearing) but I have vitreous cells of 1.5+. My vision in my right eye is hazy, with tiny black dot floaters and larger strand floaters that move around and often make is difficult for me to read/focus. Are these permanent or will they calm down/go away when the inflammation goes down? "
you have vitritis present and perhaps intermediate uveitis or posterior uveitis causing cells In the vitreous. this comment doesn't tell me the exact location of the virtreous has and cells (front of the vitreous would be intermediate uveitis) back of vitreous would be posterior vitritis linked to posterior uveitis.
the haze will resolve when the inflammation stops but the cells will take a long time to 'settle out' to the bottom of the eye where they can be stirred up and cause problems ( I have this too and my pan uveitis has been quiet since about 2006 or so and the floaters and amoeba line objects (vitreous opacities) that float across my vision are still present)
until you get a doctor lined up in Florida (Dr Perez of DR Davis at Bascom Palmer) you can't start oral steroids etc.
injection to tissue surrounding your eyes might be done but you need follow up in two weeks to make sure that pressure and tissue inside the eye are Ok before starting more steroids or Cellcept or Remicade etc. please remember that the drug ENBREL is useless for treating uveitis and it has even caused uveitis. DR Foster cannot treat you without a doctor locally working with him and only you can establish a relationship with a new doctor. the increased Celebrex dose may kick in soon. if you have a local doctor or optometrist, get in for check up before you leave for florida to get a pressure check up and to make sure your optic nerve, macula etc are well. an Avastin injection may be needed to stop the vascular component of your disease process.
you won't lose your vision.
I was told that the iritis is clearing (was a 2.5+ and now clearing) but I have vitreous cells of 1.5+. My vision in my right eye is hazy, with tiny black dot floaters and larger strand floaters that move around and often make is difficult for me to read/focus. Are these permanent or will they calm down/go away when the inflammation goes down? "
you have vitritis present and perhaps intermediate uveitis or posterior uveitis causing cells In the vitreous. this comment doesn't tell me the exact location of the virtreous has and cells (front of the vitreous would be intermediate uveitis) back of vitreous would be posterior vitritis linked to posterior uveitis.
the haze will resolve when the inflammation stops but the cells will take a long time to 'settle out' to the bottom of the eye where they can be stirred up and cause problems ( I have this too and my pan uveitis has been quiet since about 2006 or so and the floaters and amoeba line objects (vitreous opacities) that float across my vision are still present)
until you get a doctor lined up in Florida (Dr Perez of DR Davis at Bascom Palmer) you can't start oral steroids etc.
injection to tissue surrounding your eyes might be done but you need follow up in two weeks to make sure that pressure and tissue inside the eye are Ok before starting more steroids or Cellcept or Remicade etc. please remember that the drug ENBREL is useless for treating uveitis and it has even caused uveitis. DR Foster cannot treat you without a doctor locally working with him and only you can establish a relationship with a new doctor. the increased Celebrex dose may kick in soon. if you have a local doctor or optometrist, get in for check up before you leave for florida to get a pressure check up and to make sure your optic nerve, macula etc are well. an Avastin injection may be needed to stop the vascular component of your disease process.
you won't lose your vision.
Mike Bartolatz
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Mike Bartolatz
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Re: Pruning
things to watch for:
increase of floaters. could be bleeding or more inflammation
flashing lights, possible detachment of the vitreous from the retina which can cause a tear and new floaters or a curtain to come across your vision. emergent situation
.
rainbows in your vision. possible glaucoma
pain inside the eye, possible adhesion between the iris and lens or it could be linked to optic neuritis
loss of central vison, could be from a transcient Ischemic attack/stroke of the eye this can be temporary lasting just a few minutes of a day or two or it could be forever. (I have had these occur and it scary stuff)
double vision, optic neuritis or swelling behind the eye causing the eye to be unable to focus.
pain behind the eye, swelling behind the eye or from posterior scleritis
a very bloody eye, can be from scleritis and the eye is painful to touch. if not painful to touch, it could be a subconjunctival hemorrhage which is often a result of taking topical or injected steroids or NSAIDS
if any of these things occur, get in to an OPHTHALMOLOGIST right away.
loss of central vision, rainbows or pain inside the eye, flashers and a lot of new floaters or a curtain coming across your vision should tell you to get to an ER at a hospital .
I hope this helps,
Mike
increase of floaters. could be bleeding or more inflammation
flashing lights, possible detachment of the vitreous from the retina which can cause a tear and new floaters or a curtain to come across your vision. emergent situation
.
rainbows in your vision. possible glaucoma
pain inside the eye, possible adhesion between the iris and lens or it could be linked to optic neuritis
loss of central vison, could be from a transcient Ischemic attack/stroke of the eye this can be temporary lasting just a few minutes of a day or two or it could be forever. (I have had these occur and it scary stuff)
double vision, optic neuritis or swelling behind the eye causing the eye to be unable to focus.
pain behind the eye, swelling behind the eye or from posterior scleritis
a very bloody eye, can be from scleritis and the eye is painful to touch. if not painful to touch, it could be a subconjunctival hemorrhage which is often a result of taking topical or injected steroids or NSAIDS
if any of these things occur, get in to an OPHTHALMOLOGIST right away.
loss of central vision, rainbows or pain inside the eye, flashers and a lot of new floaters or a curtain coming across your vision should tell you to get to an ER at a hospital .
I hope this helps,
Mike
Mike Bartolatz
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refinnej30
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Re: Pruning
Thank you Mike.
I had a Avastin injection a little over 2 weeks ago. I think my need to find info caused me to get overwhelmed. I'm currently in college and this has made school very difficult. I was seriously considering giving up school, which is almost unthinkable to me. I do have an local eye dr. and will see him before I leave. My pressure was 14, 15 and has always been about that. Would you suggest I see my Rheumatologist before I leave? I have more than enough celebrex to get me through the next 3 months.
If I have GI issues should I look into Cellcept via injection? I did 15mg MTX but had several infections and GI issues and the Rheum I was dealing with refused to prescribe me anymore or switch.
Thank you for setting my mind at ease.
Jennifer
I had a Avastin injection a little over 2 weeks ago. I think my need to find info caused me to get overwhelmed. I'm currently in college and this has made school very difficult. I was seriously considering giving up school, which is almost unthinkable to me. I do have an local eye dr. and will see him before I leave. My pressure was 14, 15 and has always been about that. Would you suggest I see my Rheumatologist before I leave? I have more than enough celebrex to get me through the next 3 months.
If I have GI issues should I look into Cellcept via injection? I did 15mg MTX but had several infections and GI issues and the Rheum I was dealing with refused to prescribe me anymore or switch.
Thank you for setting my mind at ease.
Jennifer
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Mike Bartolatz
- Posts: 6595
- Joined: Fri Feb 06, 2004 9:58 pm
Re: Pruning
are you taking an anti nausea drug to deal with the upset stomach? DR Foster often prescribes the drug Zofran to counter this. taking folic acid helps with side effects but it too can cause some upset stomach.
if it will calm your anxiety, see the rheumatologist before you go on summer vacation. can you get your college books downloaded to your computer or IPAD? you can increase font size to be able to read easier. wear brown tinted sunglasses while on the computer to help cut glare. wrap around polarized lenses help me.
if you wear glasses go to a drug store and buy some 'cataract' 'fit over your glasses sunglasses'. they come in brown and green tint. I have both depending on lighting conditions. wear a baseball cap to cut overhead sunlight too. I have yellow tinted sunglasses for at night that help a lot with headlight glare from oncoming cars ( I don't drive at night) and when it is foggy.
stay in school at all costs. talk to your college about help with taking notes if needed and other access ability issues. the sunglasses help with fluorescent lighting too.
take care,
mike
if it will calm your anxiety, see the rheumatologist before you go on summer vacation. can you get your college books downloaded to your computer or IPAD? you can increase font size to be able to read easier. wear brown tinted sunglasses while on the computer to help cut glare. wrap around polarized lenses help me.
if you wear glasses go to a drug store and buy some 'cataract' 'fit over your glasses sunglasses'. they come in brown and green tint. I have both depending on lighting conditions. wear a baseball cap to cut overhead sunlight too. I have yellow tinted sunglasses for at night that help a lot with headlight glare from oncoming cars ( I don't drive at night) and when it is foggy.
stay in school at all costs. talk to your college about help with taking notes if needed and other access ability issues. the sunglasses help with fluorescent lighting too.
take care,
mike
Mike Bartolatz
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