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Medical Forum / General / Vision / April 2005uveitis explanation - please
I've been diagnosed with uveitis (as a result of cataract surgery). I've used pred-forte drops and seem to be healing. My optometrist says he still sees a few 'cells', indicating I'm not fully healed. Can someone explain what these cells are and what it means? > I've been diagnosed with uveitis (as a result of cataract surgery). > I've used pred-forte drops and seem to be healing. My optometrist says > he still sees a few 'cells', indicating I'm not fully healed. Can > someone explain what these cells are and what it means? Uveitis is a symptom, though sometimes the cause isn't known. The iris, and parts of the ciliary body, and parts of the vascular coat around the eye are so connected that together they have a name, the "uveal tract". When parts of this structure get inflamed it's called "uveitis". When it's just the iris it's called "iritis." When these structures are inflamed, blood vessels leak protein and the clear aqueous fluid takes on a haze called "flare". White blood cells also migrate out of the blood vessels into the aqueous, and in the microscope they can be seen as tiny white dots floating around in the aqueous. So "cells and flare" are common signs of uveitis and are often used to guage your response to treatment, usually with prednisone drops. Dilating or cycloplegic drops are often used if you're sensitive to light. Although the wider pupil accepts more light, it doesn't constrict and therefore light doesn't hurt so much. -MT, OD I have had recurring iritis for years (associated with ankylosing spondyitis). It has been come considerably less frequent and less serious in recent years but I always have drops on hand to treat it when/if it recurrs. My experience is I know when it's coming. My eyeball becomes tender to the touch. If I treat it immediately it is a very minor occurence. The longer I leave it until I treat it, the longer and more severe the episode. The problem I have is if I go to the doctor at this stage there is no evidence of the problem at all and it always makes me question my judgement about the "tender" eyeball as an indication. The doctor seems seems somewhat skeptical as well. I'm don't really want to leave it until it becomes full blown to prove anything but am curious to know if anyone has had a similar experience. ----- Original Message ----- From: "Mike Tyner" <mtyner@mindspring.com> Newsgroups: sci.med.vision Sent: Friday, April 15, 2005 11:27 PM Subject: Re: uveitis explanation - please > <kemccx@gmail.com> wrote > [quoted text clipped - 25 lines] > > -MT, OD > I've been diagnosed with uveitis (as a result of cataract surgery). > I've used pred-forte drops and seem to be healing. My optometrist says > he still sees a few 'cells', indicating I'm not fully healed. Can > someone explain what these cells are and what it means? How far out from your cataract surgery are you? It is usual and expected to have an anterior chamber reaction (cells) following cat surgery(seen in post-op care) and this doesn't indicate a true iritis. frank Thanks for the reply and followup question - The surgery was on 12/14/04. Per my surgeon, I stopped using drops a month after the surgery. He said I was completely healed - goodbye - see you in 3 months.I've since left this doctor due to non-communicative style. I still felt something was wrong, went to another ophthalmologist a month later and he found the uveitis and put me on pred-forte and acuvar (or acular) for 10 days. He said it looked all clear - and to slowly wean myself off of the drops. This week, i'm without the drops and will see him again on Monday. I saw the optometrist last week, when he saw the 'cells'. I assume that 4 months out, I should not still have this complication. NOTE: I get more out of this newsgroup than from my own docs! Karen > Thanks for the reply and followup question - > The surgery was on 12/14/04. Per my surgeon, I stopped using drops a [quoted text clipped - 8 lines] > out, I should not still have this complication. NOTE: I get more out > of this newsgroup than from my own docs! Karen Karen, one can have a persistent uveitis after cataract surgery but if the initial anterior chamber completely cleared up it's hard to say if this episode is from the surgery or just co-incidental. If the O.D. just saw a couple of stray cells versus a more moderate reaction with flare means there is an improvement. Good luck. frank Most cataract patients have not problems after surgery. I seen them back at 6 week - off the steroid drops for about 2 weeks, and check for uveitis, among other things. Some do need prolonged treatment. The second doctor, at least, realizing you weren't acting like the average, should have seen you back on the drops, later in the taper, to see if all was quiet. If not, that would have been the time to re-up the treatment. Note that some eyes do not react well to the foreign body of theimplant in the eye, and take a long time settling down. A very few never do, and the implant needs to be removed. Some can stay on a little steroid indefinitely to keep the iritis under control (ie once a day or so.) On 4/16/05 2:10 PM, in article 1113685849.807660.67660@o13g2000cwo.googlegroups.com, "kemccx@gmail.com" > Thanks for the reply and followup question - > The surgery was on 12/14/04. Per my surgeon, I stopped using drops a [quoted text clipped - 8 lines] > out, I should not still have this complication. NOTE: I get more out > of this newsgroup than from my own docs! Karen |
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