Re: Re: new, need advice on uvitis

[Guest guest]

, the implant was an ahmed valve implant. It works by pumping

the fluid from the eye. When fluid builds up, the eye pressure (IOP)

goes up. The side effects from using long term steroid drops to the

eye (pred) can cause the pressure to go up...causing glaucoma.

Inflammation can also cause the pressure to go up. We have a catch 22

here...as we can go blind if we don't treat it...and the meds we have

to take can also cause the pressure to go up. However, we have no

choice but to treat the iritis/uveitis regardless to the side effects

of our meds.

Got off track here about the ahmed valve implant. When drops, to bring

down pressure, no longer works, the treatment, at the time I had

glaucoma, usually involved valve type implants. We have a special kind

of uveitis (chronic inflammatory uveitis), and they have found that

valve type implants have more success than other types of surgery for

glaucoma which involve chronic inflammatory (trabeculectomy, laser,

etc.).

That said, there are now available different types of treatment for

chronic uveitis and chronic IOP. It is now possible to have little

tiny balls of med (steroid/IOP drops) inserted directly into the eye

ball and can deliver a constant small dose of steroid to control

uveitis. It seems to be better than just constant drops into the eye.

This is done only on people who have chronic uncontrolled uveitis,

when just drops to the eye, do not work any longer.

I also had a vitrectomy after my glaucoma implant. This helped with

the constant inflammation to the vitreous (center of the eye ball) and

I was able to see better after this operation.

My Rheumatologist prescribed the plaquenil. My opthalmalogist had me

consider this medication also, so they know about it. They will set up

appointments every 6 months to check for any side effects (retina)

from the Plaquenil. This side effect is so rare on the low doses of

Plaquenil that I hesitate to even mention it. Plaquenil can sometimes

help with the arthritis. Below is a web site explain how the implant

works.

http://www.glaucoma.org/treating/glaucoma_valve.php

[Guest guest]

Tim,

There are many here that feel for you and your Mom and I hope her eye

condition improves soon. As mentioned, the typical course of action in

battling uveitis is with lots of steroid drops that are slowly tapered off.

However, there are a few of us, like Connie and myself, who have experienced

chronic uveitis and suffer other complications, like glaucoma. Like Connie

mentioned, your mother's high IOP is a concern. Hopefully, that is under

control now. However, steroid eye drops, like Pred Forte, can elevate the IOP.

I hope you will be able to find some good ophthalmologists in your area. Your

mother may need more then one specialist, perhaps a uveitis specialist and a

glaucoma specialist. Good luck.

---------------------------------

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[Guest guest]

Tim, it sounds like your mother is being treated properly. The

dilation drops are used for a short while to break up any scar tissue

that might be formed from the eye inflammation and when they see no

inflammatory cells (through slit lamp exam) and when the IOP is in the

normal range (think you said 16) for a couple of months they will

taper and discontinue the dilation drops and the IOP drops. The pred

drops have to be slowly tapered also. Like mentioned, she

will have to be checked very closely for the high IOP. Glaucoma is

painless and you can lose vision very fast.

Yes, the steroid drops can cause cataract, however, we still have to

use it for this type of eye disease or risk rapid blindness. There are

no other options except those I mentioned. The plaquenil might not be

an option for her....as she seems to be subject to another type of eye

disease? (which might have something to do with the retina? just

guessing here.)

Your mom's experience with eye infammation sounds very similar to

mine. It has been a long journey. Mine started in my late 30's, I'm 72

yrs old now. +Dave and I are the old " foggies " in the group. I know I

put a couple of opthalmalogists, glaucoma specialist's children

through college by the care they gave me! Some good doctors, some bad,

some excellent. My first opthalmalogist learned through trial and

error what was good and what was bad for me, but he learned his art

too late to save me from glaucoma and the expense of so many vials of

pred forte. Maybe his next uveitis patient will gain from our

experience. A vitrectomy at an earlier age would have prevented a lot

of pain and heart ache. I now have three excellent eye doctors (all

different specialties) and finally have my uveitis and glaucoma under

some control.

Best wishes for your mom and you, Connie