Hello guys,
Beautiful Sunday and a stunning Easter Celebration. Happy Easter to all believers out here, may the days ahead be great even as we make preparations to step into the new month. I do hope that we are all doing amazingly well and having a good time.
As usual, seeing me around means I probably have something to share concerning healthcare in general or as my specialty would demand, a focus on eye care. Today I want to tell you a medical story about one of my patients and hopefully encourage us all to do better.
Our eyes are such a delicate organ that sometimes taking things for granted even in the least of ways could come back to haunt us so dearly, we lose something we cannot get back and then our lives are severely impacted forever. And so let's endeavor to be particular about our ocular health.
Let's learn something about pan uveitis, I hope you stay through the read and you are always welcome to leave your comments below or reach out if you have anything concerning your eyes you would want to discuss.
Pan Uveitis
A 27-year-old male presented to the eye unit of my hospital with complaints of severe pain and the reddening of the left eye for the past 3 weeks. His vision had been getting worse since the pain started and currently, as at the time he walked into the hospital he had realized that the eye could no longer perceive anything except light in the room.
When I inquired as to why he had waited for 3 weeks enduring all that pain and not coming in for care, he said he was hoping that the pain was going away. It was the fact that his vision was severely deteriorating that got him to come in for care.
Routine examination revealed his vision as HM in the left eye and 6/6 in the right eye. His entire media was so hazy that light couldn't go into the eye for fundoscopy to be done, slit lamp examination revealed giant Kps and a very hazy vitreous after dilation of the eye. Lens changes were noticed.
I proceeded to explain to him that he had what was referred to as pan uveitis and the implications of having to wait so long before coming in. The treatment is going to be hard and aggressive because of the level of inflammations going on in and out of the eye and that uveitis is a possible blinding condition although it is very much treatable. He also had to understand that the lens within that eye has undergone some changes so we could only be hopeful that we get his entire vision back.
Because I had to put him on steroids I had to order some lab tests to check for syphilis, tuberculosis, toxoplasmosis, and HIV, and thank God they all came back negative, unfortunately, it also meant that the source of inflammation is unknown or idiopathic. He was put on antibiotics, steroids, and antiglaucoma drugs because his IOP was over the roof and he had to come in at shorter intervals.
Now he's still receiving treatment and his vision has started to improve a bit, his vision has increased to CF at 3m which is a good sign however what I seek to draw our attention to is the fact that the condition could have been managed at its early stage such that his vision wouldn't have gotten that bad and treating wouldn't take as long as it would take now. And there's a good chance we might not get his full vision back or there would be a complication of cataract formation at the end of everything.
Conclusion
I know many of us have good tolerance levels for pain, some more than others but when it comes to your health I would advise that we do not hold in pain just because we can do so. Be quick to seek consultation or care because pain is always an indication of something wrong somewhere in our bodies.
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Remember your sight is your light to this world and its being compromised could drastically affect your quality of life. Take good care of yourself always, avoid over-the-counter medication, instead have regular checks, and when in doubt speak to a professional.
Further Reading
Tsirouki T, Dastiridou A, Symeonidis C, Tounakaki O, Brazitikou I, Kalogeropoulos C, Androudi S. A Focus on the Epidemiology of Uveitis. Ocul Immunol Inflamm. 2018;26(1):2-16. doi: 10.1080/09273948.2016.1196713. Epub 2016 Jul 28. PMID: 27467180.
Teo AYT, Betzler BK, Hua KLQ, Chen EJ, Gupta V, Agrawal R. Intermediate Uveitis: A Review. Ocul Immunol Inflamm. 2023 Jul;31(5):1041-1060. doi: 10.1080/09273948.2022.2070503. Epub 2022 Jun 27. PMID: 35759636.
Gamalero L, Simonini G, Ferrara G, Polizzi S, Giani T, Cimaz R. Evidence-Based Treatment for Uveitis. Isr Med Assoc J. 2019 Jul;21(7):475-479. PMID: 31507124.
Wildner G, Diedrichs-Möhring M. Resolution of uveitis. Semin Immunopathol. 2019 Nov;41(6):727-736. doi: 10.1007/s00281-019-00758-z. Epub 2019 Oct 7. PMID: 31591678.
I want to appreciate your approach doctor. Eye is our sensitive organ we should not take any risk regarding it. We should guide patient regarding his 3 Week late's appointment what damaged had done. I learned from your post about Pan Uveitis. I was expecting totally Opaque Lens condition. If the problem has suffered severely eye lens then change of eye lens will be the solution. I 'm just thinking about the cost effect. Imagine if lens replacement costs only 500$ and treatment costs 700$ then I shall give preference to first condition. Very nice post.
Well len's replacement is not so much expensive however for that possiblity to be considered the inflammations must have subsided completely and fundus still in good shape. A lot of times, especially in the case of toxoplasmosis being the cause of the uveitis, retinal scars or even macula scars may come about making lens replacement a bad option
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