It's been a while since my last update. I have been on NSAID's since June and have not had a flare however just recently I started wearing contacts (more off than on). Last week I noticed that my eye was a little red. I put a drop of FML and seemed to clear it up. I was just wondering if my contacts are to blame. The last eye appointment I had, the doctor saw a couple of cells but she was thinking that this is my baseline. My next eye appointment is scheduled out for a year unless I'm having issues.
I'm HLAB27 positive and have been having tingling in my back and now my neck has been hurting. The tingling started way back when I was on prednisone-it comes and goes. I've also gone to the chiropractor, my neck is getting better but still hurts. Any suggestions?
if you are having possible active arthritis in your spine, neck etc, call and get your eyes checked out as the eye could be impacted with inflammation.
for your information, all solutions to clean contacts should be discarded after 90 days. the storage container for the contacts should also be discarded after 90 days. eye makeup should also be discarded. it is easy for all of these things to become contaminated and lead to bacterial infection while on corticosteroids. putting a new set of contacts into a contaminated container or using contaminated solutions can lead to infection while on corticosteroids. these precautions shoud be followed even when NOT on steroids.
wait at least 15 minutes after instilling the steroid eyedrops before putting in the contacts. if you are on more than one eyedrop, wait about 10 minutes or as directed by your opthalmologist.
I hope your eye is quite (just a couple of cells).
if you have dry eyes (common with HLA B27 patients) consider using a lubricating eyedrop before you put the contact in. preservative free single use vials of something like Refresh etc are available and are recommeneded as the preservatives in eyedrops can lead to allergic reaction called 'medicamentosa'. dry eyes can lead to corneal abrasion as the tear film isn't properly composed of fluid and lubricant secreted by the myemobian glands in the eyelids. this could happen with a contact that isn't lubricated. bacteria can then enter the cornea or conjunctiva and then you've got a mess on your hands.
Re: Update
Thanks Mike. I made an appointment to see my eye doctor. I really hope the uveitis is not back. At least I now know what to look for. Unlike the time I first came down with uveitis-that was horrible. I would never wish this on anyone.
The contact information I already knew but it's a nice reminder-thanks
Re: Update
I just saw my eye doctor, she said everything looks great. There are no cells and my eye's look better then my last appointment in August. She also said that the redness is because my eye's are dry. So I guess it's back to using rewetting drops.
Re: Update
use LUBRICATING eyedrops, non prescription that are in single use vials (no preservatives)
i buy Refresh Plus brand. put this in before you put the contacts in. ( I can't tolerate contacts because my eyes are too dry)
for dry eyes they can implant plugs in the drains of your eyes. I had this done and it helps allot during the day and at night but I still have to put a drop in a couple of times during the night or my eyelids start sticking to my eyeballs. not pleasant. they can put in Collagen ones that last a day or so. this will tell if this is an option for you.
do you have a systemic autoimmune disease going on? do you have non granulomatus uveitis or granulomatus uveitis?
often HLA B27 positive members complain of severe dry eyes.
it is also associated with Sjogren's syndrome, Systemic Lupus Erythematosus and other connective tissue diseases.
Sarcoidosis is granulomatus uveitis and it can appear in any part of the eye and it too has severe dry eyes as a component.
the topical eyedrop Restasis is available too to get the lacrimal gland inflammation under control if your cause of the dry eyes is not from some other cause.
do you get crusty eyelids? often blepharitis occurs along with severe dry eyes. Lid hygiene using babyshampoo in very warm water several times a day, massaging along the lash line helps unplug the myemobian glands. the antibiotic Doxycycline is used to treat this too both for it's antibiotic effect and it's anti inflammatory effect.
you should ask the opthalmologist to measure your tear output if not already done. dry spots on the conjunctiva or cornea can be seen with the slit lamp and a dye on the surface of the eye. infection can occur both on the conjunctiva and the cornea.
I'm also HLA-B27+ and have had anterior uveitis. My uveitis has been well-controlled by NSAIDs for a number of years now, but when I tried contacts, I really had trouble with dryness in my uveitis eye only. I don't have an answer for you - I gave up on contacts, but I wanted you to know you aren't alone in dealing with this.
I guess I'm not sure about the granulomatus or non-granulomatus. All that I know is that I had anterior uveitis and the Mayo clinic diagnosed me with undifferentiated spondyloarthropathy. At times my eye that I had the uveitis in feels scratchy. I'm assuming that this is dry eyes since I don't have any active cells.
Hi Beverly,
May I ask how long you've been on NSAID's? Can you be on this for the rest of your life?
Re: Dry Eye
next time you go to the opthalmologist ask if you are HLA B27 positive (the seronegative spondyloarthropathies, IE. undifferentiated spondyloarthropathies are related to this gene)
uveitis related to HLA B27 often responds to NSAID therapy. in the experience of Dr Foster, about 70% of individuals with this autoimmune related uveitis respond.
what one does is start an NSAID such as Celebrex, Dolobid (difusinal), Naproxen and one takes it for six months at prescription strength. if the eyes remain quiet, off all steroids without inflammation, then one continues at the prescription strength for TWO YEARS, then the NSAID is tapered. usually at half the prescription dose for six months. and then if off all steroids without inflammation, the NSAID is stopped.
for a steroid eyedrop, Dr Foster prefers Vexol as it stays in suspension (doesn't need to be shaken) it also has a lessened ability to cause rise in pressure inside the eye.
many optometrists and opthalmologists don't give dry eyes the concern they should. contacts can be worn and a special type called the boston lens is used to help treat corneal abrasion and to prevent corneal abrasion in dry eye patients. many of us are so used to the gritty feeling and scratchy feeling that we don't complain so doctors don't address this until there is corneal errosion or conjunctival or scleral thinning or worse, ulceration and infection. treatment can require corneal transplant as is the Case with Bob, the husband of Betti who posts here quite often. he has underlying Crohn's disease with severe eye complications from under treatment of the uveitis, dry eyes etc and is legally blind from it. Crohn's is also related to HLA B27, IL23R, ARTS1 genes and can have undifferentiated spondyloarthropathy as a consequence.
I'm having allot of problems right now with dry eyes too. the forced air heat in my eyes is contributing to this and I have to use more lubricating eyedrops.
the cold wind also contributes to dry eyes. my fit over the glasses sunglasses helps to make this manageable.
I don't know how long you can be on NSAIDs. But, I think you can stay on them for a long time, if they don't cause you trouble. Many people with arthritis take them for a very long time.
I started NSAID therapy in mid-2002. I took Vioxx, then Bextra, and finally Celebrex. I had a couple of flares during that time but certainly much less than before (when I could not get off the steroid drops without flaring.)
In July of this year, in consultation with the wonderful Dr. David Chu (Newark, NJ), I stopped the Celebrex. I had been at half dose for about a year, except during spring and fall, when I tend to flare - I went back to full dose at those times. Cross your fingers, knock on wood, and say a little prayer - I have not flared since I stopped the Celebrex. We're starting to get out of allergy season here in New Jersey, so I'm really hoping that I really am done with uveitis. Next spring will be the real test IMHO. At this point, it has been 2 1/2 years since my last flare.
I hope this is helpful, and I hope you can also find a therapy that will control, or even better, CURE your uveitis.
MIke - I agree that many doctors don't seem to quite "get" the seriousness of dry eyes. Maybe once we find the cure for ALL uveitis, we can start a campaign for dry eye.... It is only my uveitis eye that is affected, but the dryness is certainly much much worse in the winter months when the air outside is dry and the air inside is dryer.
Re: NSAIDs
Beverly.
I know that it is often recommended to get a good humidifier and keep it nearby to help with dry eyes.
It is so humid here in the Pacific Northwest of the USA that if I did that I'd be growing MOLD everywhere.
then my wife would be sick too.
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