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I Was Diagnose With Anterior Uveitis November 2017. I Was On Predisilone For 3 Months And Now Durezol Since February. Every Time The Dr. Tries To Wean Me From The Meds The Sensitivity To Light And Pain Returns More Severely. Every Routine Test For Autoimmune Diseases Were Negative. What Are My Risks? What Do You Suggest Please?
Question: I was diagnose with anterior uveitis November 2017. I was on predisilone for 3 months and now durezol since February. Every time the dr. Tries to wean me from the meds the sensitivity to light and pain returns more severely. Every routine test for autoimmune diseases were negative. What are my risks? What do you suggest please?
Brief Answer:
Important to wean off quickly.
Detailed Answer:
My dear,
It is imperative to wean off steroid at the earliest.Rebound occurred if you try to wean off quickly.Be very slow about it.What is the dose you are taking at the moment ?Usually 5 mg reduction every 3 days is usually slow enough.
steroids at your age are not welcome for such prolonged period.In the meanwhile supportive treatment in the form of NSAID is welcome.These are group of drugs which is non steroid anti inflammatory drugs.Their support helps .
Also helpful are local cycloplegic and anti inflammatory drops as an adjacent to treatment while weaning off.
Do get back to me in case of any further query in this regard.
Thanks.
Important to wean off quickly.
Detailed Answer:
My dear,
It is imperative to wean off steroid at the earliest.Rebound occurred if you try to wean off quickly.Be very slow about it.What is the dose you are taking at the moment ?Usually 5 mg reduction every 3 days is usually slow enough.
steroids at your age are not welcome for such prolonged period.In the meanwhile supportive treatment in the form of NSAID is welcome.These are group of drugs which is non steroid anti inflammatory drugs.Their support helps .
Also helpful are local cycloplegic and anti inflammatory drops as an adjacent to treatment while weaning off.
Do get back to me in case of any further query in this regard.
Thanks.
Above answer was peer-reviewed by :
Dr. Raju A.T
I've been on 1 drop 4x per day for two weeks
3x/ day for two weeks, 2x/day for two weeks. This is the third time I've tried to wean. Whenever I get to 1x/ day the pain and sensitivity returns. The eye pressure has been steady at 12 and 13 ( right and left eye) pressure in July has increased to 22.
What do you suggest?
3x/ day for two weeks, 2x/day for two weeks. This is the third time I've tried to wean. Whenever I get to 1x/ day the pain and sensitivity returns. The eye pressure has been steady at 12 and 13 ( right and left eye) pressure in July has increased to 22.
What do you suggest?
Brief Answer:
Have oral supplement.
Detailed Answer:
My dear,
Good of you to get back to me.
Though this is standard practice followed by all good doctors of tapering the eye drop,I personally do not agree with this.I in my practice support the local drops with oral anti inflammatory tablets also.This reduces our dependence on drops thereby preventing side effects of prolonged local steroid exposure.
So on tapering this time take oral anti inflammatory tablet also and now you can reduce drops more rapidly.
Have oral supplement.
Detailed Answer:
My dear,
Good of you to get back to me.
Though this is standard practice followed by all good doctors of tapering the eye drop,I personally do not agree with this.I in my practice support the local drops with oral anti inflammatory tablets also.This reduces our dependence on drops thereby preventing side effects of prolonged local steroid exposure.
So on tapering this time take oral anti inflammatory tablet also and now you can reduce drops more rapidly.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Thank you so much. Two mor questions: my vision has not changed but the eye pressure has increased. Is that permanent damage or reversible? 2. My eyelid on the affected eye is now closing ( or drooping) is that reversible?
Brief Answer:
Stop steroids.
Detailed Answer:
My dear,
Thanks for getting back to me.
This is the reason why I want you to taper off steroids rapidly.There are two major issues,raised pressure and cataract.The rise in pressure is transient to begin with.This is reversible over a passage of time if steroid tapered off now.The cataract if present is irreversible.
Another way of tapering off steroids is by using diluted steroids.many centers add equal or double the amount of saline in the bottle by injection to bring 1:2or1:3 dilution.What is the feasibility of this in your setup is to be found out as this has to be done in a sterile set up so as not to contaminate the bottle.This information is conveyed to you so that you have an idea of whole spectrum of possibilities at our disposal.
Lid drooping is usually associated with inflammation and will improve with improvement in iritis,otherwise a neurologist has to be consulted.
Stop steroids.
Detailed Answer:
My dear,
Thanks for getting back to me.
This is the reason why I want you to taper off steroids rapidly.There are two major issues,raised pressure and cataract.The rise in pressure is transient to begin with.This is reversible over a passage of time if steroid tapered off now.The cataract if present is irreversible.
Another way of tapering off steroids is by using diluted steroids.many centers add equal or double the amount of saline in the bottle by injection to bring 1:2or1:3 dilution.What is the feasibility of this in your setup is to be found out as this has to be done in a sterile set up so as not to contaminate the bottle.This information is conveyed to you so that you have an idea of whole spectrum of possibilities at our disposal.
Lid drooping is usually associated with inflammation and will improve with improvement in iritis,otherwise a neurologist has to be consulted.
Above answer was peer-reviewed by :
Dr. Raju A.T
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