Wednesday, May 4, 2011

Psoriatic Arthritis and Uveitis

I had an appointment with an eye specialist - my opthamologist - yesterday. I have seen Dr. B. infrequently over the past seven years or so, but on this visit she informed me that, "We'll be hanging out together for awhile. See me in eight weeks. And plan on coming back routinely after that."


My rheumy sent me over to see Dr. B. pronto after I began complaining about blurred vision. I told him - and Dr. B. - that this sensation is different than anything that I have experienced before, and very hard to describe.

Even though my eye exam shows that with glasses on I have fully corrected vision, I just don't SEE well. My eyes take forever to adjust from close to far vision and back again, and when they do, it seems as though one eye never quite makes the jump. And they're blurry and achey.

So yesterday we had the expected discussion about age-related changes to my eyes, the use of eye drops and ointments and the side effects that come with them, and then an unexpected discussion: uveitis.

After a thorough exam, Dr. B. made a comment that went along the lines of, Well, I'm sure that you've already considered this but we'll have to keep a close watch for uveitis - or iritis. What's your HLA B27 status?

Um. Say again?

Somewhere back in my foggy brain, I did recall reading a few things about psoriatic arthritis related eye issues. Here's what the Mayo Clinic has to say about this delightful condition:

Iritis (i-RYE-tis) is inflammation that affects a part of your eye called the iris. The iris is the colored ring of tissue surrounding your pupil. It's part of the middle layer of the eye known as the uvea, which is why this condition is considered a type of uveitis (u-ve-I-tis), or inflammation of the uvea. Because the iris is located at the front of the uvea, iritis is sometimes called anterior uveitis.
The cause of iritis is often unknown. But sometimes, iritis results from an underlying condition or genetic factor.
Iritis is a serious condition that, if left untreated, could lead to glaucoma or blindness. If you have symptoms of iritis, see your doctor as soon as possible for evaluation and treatment.
.......Signs and symptoms of iritis may include:
  • Eye redness, often seen as a bluish-pink color in the white of your eye (sclera) around the iris
  • Discomfort or achiness in the affected eye 
  • Sensitivity to light (photophobia)
  • Blurred vision
  • Floating spots in your vision (eye floaters)
Iritis usually isn't associated with discharge from the eyes. 
I also had to do some serious brain-dredging to retrieve any recollection about HLAs, which I remembered were specific parts of genes. But HLA B27? Mayo Clinic to the rescue again:
People with HLA-B27, a specific alteration of a gene that's essential to immune system function, are more likely to develop certain autoimmune diseases, such as ankylosing spondylitis, Reiter's syndrome, inflammatory bowel disease and psoriatic arthritis. Acute iritis may occur in people with these diseases.
Rats. So.....along with dry eyes, I have the potential to develop something which left untreated could lead to serious visual impairment?!?

Dr. B. noted my response and quickly told me that at this point she could not see any evidence of uveitis on exam, but that my symptoms along with my PsA diagnosis awarded me the dubious honor of becoming one of her circle of frequent fliers. Woo.

They'd better serve snacks on this flight.

Image found here.


Anonymous said...

The hits keep on coming. Wow, Julia, another biggie to deal with. My opthalmologist schedules my visits for every 6 months, and I don't have any problems except for dryness and redness in the eyes. I did just go through some viral infection, where I was diagnosed with conjunctivitis and given antibiotics (again!) and ointment for the eye. My eye was inflamed and had discharge, which made my vision blurry. It's quite scary when you can't see properly.

Thankfully, your doctor will be keeping an eye on you (couldn't resist!), and if there's a problem it will be dealt with promptly. Keep well, and hopefully all will be well.

annie said...

Sorry, I pressed too quickly before I put in my name, but the anonymous person is moi, Annie!

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