Iritis and scar tissue

[emilylawley]

Hi there, I am a 25 year old female and I have been dealing with Anterior Uveitis for about 15 months now. Let me start by giving you a time line of events that I feel are significant, but have been blown off by the eye DR's I have seen. It started in Dec '06 when I started to get severe migrane headaches every day, starting from behind my RIGHT eye. I went to see a DR about them and was told to take OTC meds and sent for an MRI. The MRI came up clean but in April of '07 a "blind spot" appeared in my RIGHT eye, overnight. It's not very large, sits slightly to the right of center, and is grey and non-translucent. When I saw an eye DR about it I was tested for parasites and some other common diseases and was eventually told that it was scar tissue. In July of that year I had my first bout of Iritis, in my RIGHT eye. Since then I have had it 6 times, all in the right eye except one time in May when in was in both. I am perscribed Pred Forte every time, sometimes with dialating drops, and then am weened off for a couple of weeks. I've been tested for a bunch of the common contributing diseases and HLA-B27. All neg. Are the migranes and "scar tissue" significant? Am I really going to have to deal with Iritis every other month for the rest of my life?? I should also note that I deal with what I call "phantom pain" in between my bouts of Iritis. It feels like the Iritis might be coming back and then disappears in a day or two. Usually the pain is at night. It kind of feels like someone is pressing their thumb against the inside of my eye, trying to push it out. Is this normal and/or related?? The eye DR's I have seen all seem to blow me off and try to get me out of the office as quick as possible. I just want someone to listen and give me a good idea of what I am dealing with.
Thanks in advance for any help,
Emily

[John C Hagan III, MD, FACS, FAAO]

I suspect they are related and I would ask your Eye MDs to consider having you seen by a rheumatologist.

JCH MD

[emilylawley]

Hello again,
An update with questions.... Since this last post in Nov I have been diagnosed with two different inflammatory eye diseases and had another blind spot appear in my field of vision, this time in my left eye. About 3 weeks ago I was diagnosed with pingueculitis in my right eye and then a few days ago with scleritis in my left eye. Should I be on some sort of NSAID theropy? Are these all related?? As I said earlier I have been tested for everything in the book, and everything is neg. I can't really be that unlucky can I? 3 different inflammatory eye diseases all popping up with in a few months of each other, there must be something that the DRs are missing right?? I am out of ideas and have searched the internet high and low looking for answers.
Thanks in advance for your help
Emily

[Flavius G Pernoud III, MD]

Uveitis can be frustrating for the patient and the doctor. It may occur spontaneously in an otherwise healthy individual. Recurrences are common--usually in the same eye. There are many many causes which can be difficult to uncover. I am a little surprised that you are weaned off the drops in a "couple of weeks". Even though you may be better, sometimes it takes many weeks to get off the drops completely. The intermittent pain you complain of may be "ciliary spasm" or a spasm of the ciliary muscle which focuses your eye caused by low grade inflammation in the eye. You may need more long term dilation with a cycloplegic drop to keep your pupil dilated--this paralyzes the ciliary muscle and puts it at rest.

You may need to see an ophthalmologist who specializes in uveitis. You can usually find one at a major teaching hospital associated with a medical school or ophthalmology residency program. Also, sometimes a consult with an infectious disease specialist is warranted. Here is a short list of associated conditions. Rheumatoid or lupus, Ankylosing spondylitis, sarcoid, TB, syphilis, Lyme, toxoplasmosis, leprosy, brucellosis, etc.--you can begin to see the problem. Check out Vogt Koyanagi Harada disease.