Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Iritis

Blimey Molly at this rate I will get the after dinner mints and the coffee ha ha.

IOP in right eye is 17 which is pretty good but she said left eye is very low but didn't give me a reading. My left eye has always been my weak eye.

Kevin

Oh I understand now, thanks for explaining Kevin.
Hope for your sake it is borderline and not at the treatment stage.
Ever feel like you are falling apart?
Don't worry, we'll hold you together and make sure you don't

I cant fall apart Tink I'm all fused together

Kevin

Oh yes, good point
Glad to see you have not lost your sense of humour

Hey Kevin, I'm dealing with Ocular Herpes, but the symptoms and treatment are similar. I struggle with high pressure in one eye (it was 56 a few months ago, but back down to 16). I'm going in to see the doc tomorrow because my vision is really bad and it is very tiring trying to see out of 2 very different visioned eyes (does that even make sense? LOL)

Well, at least if you fall, it will be in one piece!

Crappity crap crap crap! Sorry about the eye issues you're having.

But you'll get to feel good when you get your enbrel. La la la la la la live for today....

IF the left eye is low then that is good. 17 is a tad on the high side. Now, need to check for retinal damage - that's where the Humphrey (checks for sight lines/peripheral vision) and the Heidelberg Retinal Tomograph to check the retina come into their own. The HRT3 is the crucial test, or with an OCD (which will do the same thing). My retina is severely damaged, though pressures are low - LTG, low/no tension glaucoma. Pointless taking th glaucoma drugs for LTG as there is NO tension to be treated! My right eye varies between 14 and 18 (initially was at 23) the left eye between 8 and 12. The right eye is glaucoma with severe retinal damage.

The glaucoma drugs are pretty dire. Many side effects - and (eventually) *much non-compliance by patients! There is an op, Trabeculectomy that shows good results - there are other procedures as well (see below). Got to be done in the right hands. Not too many ophthos are up on it! There is a good man in Bournemouth, excellent track record. Charles Richardson - who has made the op pretty much his own! (Will be seeing him when I'm next over). Here's some info on the procedures various:-

http://www.surgicalservicesinternational.com/glaucoma.htm

Laser Peripheral Iridotomy (PI)
Argon Laser Trabeculoplasty (ALT)
Glaucoma Drainage Device (Tube Shunt)
Glaucoma Filtration Procedure (Trabeculectomy)
Cyclophotocoagulation

Meantime, I use Acetyl-L'CarnoSine, which has brought the IOP down from 23 (which is barely an 'elevated' IOP) to a respectable 14/18. Pressures will vary on time of day and pressures can also be linked to BP. Interesting reseearch work is slowly emerging on glaucoma. Was thought until recently that BP bore NO relation TO glaucoma, but recent research has changed that opinion. Is also found that low BP at night is especially detrimental to glaucoma. Another item that came my way, was that glaucoma is not unknown amongst AS patients! Latest stuff I was reading was linking glaucoma to autoimmune conditions. Interesting.

Will send any interesting info I come across onto you Kevin. As well to be fully into whatever pictures are available. Then at least you have a choice as to which path YOU would like to follow.

Take care -

BTW - was 'assuming' that your glaucoma is open angle glaucoma? Was just reading the site I posted and this procedrue is specifically advised/recommended (over other proceddures) for those patients who also suffer with iritis. Very interesting:-

Glaucoma Drainage Device (Tube Shunt)

"Glaucoma drainage devices, also known as tube shunts, are implanted devices that are designed to maintain an artificial drainage pathway for patients with glaucoma . This procedure is often chosen for patients at high risk of failure with a traditional glaucoma filter procedure (trabeculectomy). Such patients might include those with neovascular glaucoma, glaucoma associated with uveitis (iritis), prior history of failure with a filter procedure, and any patient with glaucoma under 30 years of age. All of these patients are at significant risk for failure of a routine glaucoma filter procedure due to greater inflammation and fibrosis (scarring), which might close off the drainage canal .

Tube Shunt Implantation—The Procedure

Prior to surgery, your ophthalmologist may have you take eye drop medications to prepare your eye for surgery. These may be begun on the day of surgery, or even up to 3 days prior to surgery. Just prior to surgery, local anesthesia will typically be given to numb your eye for surgery. In young children, the procedure must be performed under general anesthesia. Just prior to surgery, a local anesthetic is usually given unless the procedure is to be performed under general anesthesia. Your eye will be prepped in the operating room and sterile drapes placed to maintain a sterile field. An operating microscope will be moved into place. The surgeon will place a small instrument to hold the lids apart during the surgery.

A small incision is made in the conjunctiva , usually towards the top of the eye, however, the surgery may be performed in other quadrants of the eye. The surgeon will then make a tiny incision in the sclera of the eye and will fashion an opening for the drainage implant device. The drainage tube will be placed such that the opening of the tiny tube is inside the anterior chamber of the eye where it is bathed in aqueous fluid.

The tube is sutured in place with the drainage device attached to the sclera of the eye. Most surgeons will place an absorbable suture around the tube at the time of surgery to prevent filtration through the device until a fibrous capsule has formed. As such, the device is not expected to function until about 3 to 8 weeks following the procedure. This technique is thought to prevent over-filtration. Once the tube shunt is securely sutured into the desired position, the conjunctiva over the device is closed with tiny sutures, which are considerably finer than human hair.

After Your Operation

As previously stated, the tube shunt device is not expected to function until 3 to 8 weeks following surgery. In the meantime, the glaucoma may be even more difficult to control than before. Some surgeons, therefore, create a separate glaucoma filtration site, which is expected to fail at approximately the same time that the tube shunt begins to function.

You will be instructed to use antibiotics , anti-inflammatory medicines, and probably glaucoma medications following the procedure. The actual medicines and dosing schedules will be carefully planned and reviewed with you by your eye surgeon or his staff. You may expect to use these additional medicines for up to two to three months after surgery to help prevent infection and control inflammation.

In general, you will likely be able to return to most activities within a day or two after surgery. Your eye may feel scratchy or have a foreign body sensation. This should usually resolve in the first one to two weeks. Your surgeon will instruct you as to strenuous activities.

FAQ's

When Can I Expect the Final Results?

The efficacy of the tube shunt implantation usually won't be known until at least 8 to 12 weeks after surgery or more. At that time, a new baseline level of pressure within your eye will usually be established.

Will My Glaucoma Be Cured with the Tube Shunt Device?

In general, glaucoma cannot be reversed. The damage which has ensued prior to surgery is essentially irreversible, since the optic nerve does not regenerate. The best result that can be expected is a complete halt of the progression of glaucoma. This can only be known by following visual signs of the optic nerve and evaluating peripheral vision with visual field testing .

What are the Risks with a Tube Shunt Device?

The risks of this procedure include, but are not limited to, over-filtration (pressure too low in the eye), under-filtration (pressure remains too high in the eye), infection, bleeding, swelling of the retina , fluid under the retina (choroidal detachment), droopy eyelid, double vision, loss of vision, and even loss of the eye. In general, however, if your surgeon recommends a tube shunt implantation, he or she believes the benefits of the procedure far outweigh the potential risks.

Will I Still Need Medications After a Tube Shunt?

All patients will need eye drop medications to help prevent infection and inflammation after a tube shunt implantation, usually for the first two to three months. After that, use of glaucoma medications to further control pressures will depend on the outcome of surgery, i.e., the pressure in the eye."

I haven't ever had iritis till date. I had this feeling of discomfort in the eyes and have gone to the eye specialist, but it came negative. In the last month i have the feeling of redness, blurring of vision when i work too much, watery eyes, and if i rub my eyes then they turn red. Are these iritis symptoms? Any idea what i should do? Go again to a eye specialist?

You crack me up!