inflammatory eye concerns

[abhi_1122]

Our beloved Dr. Jon, My question will be distributed into parts so that it can be answered in step by step sequential manner:-
1. usually its argued that inflammation is natural healing process of body to heal injuries which used to make me wonder why doctors prescribe nsaids for a simple acute backache from a fall or sports exertion. After research I came to know, that its the chronic inflammation which is damaging to the structures of body arising out of autoimmune conditions . Hence , i have observed that many times if i avoid painkillers after injury , the injuries just heal fine automatically which makes me think that drugs can be avoided in acute conditions. Now i will transition my point in case of an eye. Suppose a person gets hit to the eye, assuming that there is inflammation inside the eye , maybe anterior/posterior ....uveitis/iritis . In such cases,if steroid drops to control inflammation are not given , can eye recover well from the injury in many cases ? as its the injury induced inflammation and not the autoimmune chronic inflammatory process....so prescribing drops to control pain would rather delay the healing process which is occuring due to inflammation. Am i right? What if patient is ready to bear the pain and does not take anti-inflammatory drops like prednisolone . Can he heal in that case? I am assuming there is no hyphema.
2. Its said that inflammation can damage the healthy tissues .....does it apply to acute injury cases as well? Can person suffer permanent blindness or non recoverable damage from acute inflammation of eye?
3. For how long can inflammation in the eye really go untreated before it goes on to actually damage healthy structures?
4. If inflammation causes any blindness, are doctors upon dilated eye exam always able to identify which structures have been compromised/damaged? .  I have seen eye doctors many times saying that they are unsure how much vision patient will recover after injury . Now lets say for example, a person recovers 70 percent vision. Then can eye doctors atleast check whats the reason behind 30 percent compromise, which parts of the eye have become deficient or which structures are not working well...Or these subtle damages dont even come in eye examination.
5. When i was having pain in my eye few months back, i suspected inflammation. I did video consultation with opthalmologist. She asked for pictures of my eyes and talked to me on video call. She said , everything looks normal . now i want to know , whether without slit lamp , can opthalmologists grossly check inflammation really well. Can they atleast know , if a physical examination is needed or not. My physical eye exam after one month of video call came out fine. But i just regret that i should have gone to the doctor in start itself rather than taking video consult.
6. Last point i also want to know what happens if anti inflammatory drugs are not given after cataract surgery ? Are there any cases, where post op cataract sugery pain /inflammation was not controlled with nsaid/steroid drops and then patient still recovered very well. Surgery to the eye is also a kind of trauma in one way . And if complications arise due to non administration of anti inflammatory post cataract surgery , whats the prognosis of complications or vision in such case?

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

1. It is possible to have a mild iritis resolve without steroids. However moderate or severe iritis left untreated without steroid drops and dilated drops can cause the iris to scar shut, cataracts, glaucoma and permanent loss of site.  If an ophthalmologist prescribes steroid drops take them.
2. Inflammation runs from very mild like a spot of poison ivy or small cut, to overwhealming inflammation that can kill a person. That is like saying "how bad is a automobile accident"  can't generalize

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

3  Varies and cannot generalize.
4.  I'm backing out of this discussion. you seem to be mounting a case not to take steroid eye drops prescribed by an ophthalmologist and I'm not going to be part of that.