Eye Trouble

[Boozsa]

I have a chalazion or inflammatory bump on the inside of my bottom right eyelid, you can see it and it makes my vision blurry in that eye only. My prednisone has been reduced to 15mg from 20mg in the last week. Should I be concerned that my eyesight is at risk again or is this a common thing that can happen when reducing prednisone? Also, I am having surgery to remove my thyroid on Dec 2 due to thyroid cancer and Acquired Atrophic Thyroiditis, and concerned if I am having an inflammatory flare up, should I notify the surgeon? Don’t want to overreact, just want to be safe... having surgery while on high dose Pred has me a little nervous anyway.

[SheffieldJane]

I can understand your wanting to be safe and to do everything in your power to ensure that. I hope that your operation goes really well and you recover quickly.

I have a not very noticeable swelling just above my eyelid that I think has been caused by a blocked tear duct. I use moisturiser around my eyes which may have triggered the condition. My optician could hardly notice anything but when I have my upcoming Opthalmologist appointment I will discuss it. I haven’t noticed that blurred vision is particularly associated with the affected eye, both when I am very tired. I do have dry eyes, associated with my autoimmune conditions and probably Pred too. I understand that it can be drained.

You will need to take advice about steroids from your particular surgeon as he/ she will have their own preferred course of action, and recommended dose which the Anaesthetist will supervise.

That was quite a steep Pred reduction, I was doing 2.5 at that stage. How are you?

I think your Surgeon will want to know everything you think is relevant.

[Boozsa in reply to SheffieldJane]

I’ve had a rough time getting down from 20 mg , really since 25mg even no matter how I reduce but I have permission from the prescribing doc to increase by 2.5mg if needed they just harass me about going up instead of down and I get tired of it. I’ll make sure to tell the surgeon if I adjust again today, he was very informed about stress doses throughout surgery to keep me safe I’m just nervous, naturally thanks for the response

[SheffieldJane in reply to Boozsa]

Of course you are nervous. They are taking something away that is no use to you anymore. I imagine that you still carry some trauma from all that you have already been through with thyroid cancer and the subsequent atrophy of the gland. I hope they give you a pre- med. I had one, once and I just loved everybody. Sending you a big hug and a hand to hold. Let us know when you are up and running again!

Ignore the harassment it is so ill timed, none of us can taper down when we’ve got huge stuff going on. You’ll get down later, in your own time. 🌺

[DorsetLady PMRGCAuk volunteer]

Agree with Jane, this needs to be discussed with surgeon/anesthetist .

[Twopies]

I get chalazions all the time—have one now, in fact. Eye doc said to use warm compress 3 times a day and massage just under it. they usually resolve in about a month. Never had them before pred; also I’ve had severe dry eyes with pred, and developing cataracts. Oh, the joys!

[Boozsa in reply to Twopies]

Thanks for this Was guessing it was a Pred thing just wanted to make sure my eyesight wasn’t an emergency/ I’m using the warm compresses now. I will still contact eye doc on Monday if not better and inform the surgeon if necessary.

[Hollyseden in reply to Twopies]

Interesting that you mention really dry eyes. I have that quite often. At its worst in the morning when my eyes feel so dry I can hardly open them when I waken up. Joys of pred

[PMRpro Ambassador in reply to Hollyseden]

It may not be the pred - it cay be sicca syndrome which is not uncommon alongside many autoimmune disorders including PMR

[Hollyseden in reply to PMRpro]

I've had drops a couple of times from doctor for it. No mention of sicca syndrome? It comes and goes though so I haven't bothered much about it, my eyes are ok when I've been up and about for a while. 🤞

[PMRpro Ambassador in reply to Hollyseden]

He probably doesn't know what it is!!!! The optician/optometrist is the person to ask about dry eyes. I used a liposomal spray for a long time. it is better now. You use the spray onto your closed eyes and used before bed it does help the gritty eyes in the morning. I used Clarymist then as my wonder-optician swore by it, quite rightly - it's under a different name now, Eye Logic. As it is a spray and doesn't touch the eyes the bottle lasts for months, doesn't go off in a few weeks like drops do.

eyesolutionsonline.co.uk/ey...

[Hollyseden in reply to PMRpro]

Strangely enough I did mention it when I last had eye test. He wrote down name of drops he recommended I ask doctor for. I did this and surprise surprise, doc gave me something else. 🤔 Cost motivated maybe but anyway they did work.

[PMRpro Ambassador]

You might find this helpful:

allaboutvision.com/conditio...

It may be related to the pred in that that may make you more likely to develop styes.

Your surgery team needs to know all the details of your medical history - and do make sure they register it all at the pre-op assessment and that the anaesthetist knows, not just the nurse who may do the appointment,

[maria40]

I've had one beneath my upper eyelid for some weeks now. A couple of months ago I got the first stye I'd ever had in my life, followed by two more and now this. I don't think it's pred related as I've been taking it for 19 years. I've had a little blurred vision as well . I self diagnosed blepharitis but think I'll make a GP appointment having read this thread.

[Leilagirl]

Stye response— once I became diagnosed with PMR and started on prednisone I do not know if prednisone is a factor related to this, the doctor say a lower immune system may be. I do get styes frequently five in one year last year upon diagnosis . Hot compresses four times a day for 15 minutes minimum at a time the more hot compresses you can use the quicker This stye will go away. I did see a doctor with each stye and all them had nothing to offer other than keeping my eyelashes clean .. using baby shampoo on a Q-tip is what they recommended and lightly massaging them when I do clean them with just warm water and hot compresses. Remember I am not A medical provider just someone who gets frequent styes ...they will go away. 3-4 weeks duration for me .As I have taper down on prednisone they are almost nonexistent now. It could be because I’m doing better physically or I’m on a lower dose of prednisone don’t know... best of luck to you.

[SheffieldJane in reply to Leilagirl]

I think a chalazion is slightly different to a Stye, I had to look it up. Apparently it means a Little Rock in Greek. It is not painful and tends to be a bit of hardened oil. So I learned something.

[Leilagirl in reply to SheffieldJane]

Yes That’s what I understand as well but the warm washcloth or the warm compresses often will help dissipate that oil as well. At least I believe that to be the case thanks

[PMRpro Ambassador in reply to SheffieldJane]

It is the sign of an internal stye - the infection is not released to the outside so it swells.

[SusanEleven in reply to Leilagirl]

This is me! I’d had only one stye in my life until this year. Looks like I’ll end 2019 with a total of three. Eye doc says I’m producing so much oil. I have to shampoo the lashes daily, “milk” the oil by using cotton swabs, and do the hot compresses as you describe. For me they didn’t start until my prednisone dose was lower, around 3mg.

[Orpheus82]

It’s also advisable not to wear make up until it goes. Wash your hands thoroughly before touching the eye and don’t share towels. There’s a slight difference between a stye and a chalazion. Styes tend to be an infection at the base of an eyelash and will often discharge more readily. A chalazion or meibomian cyst are formed by a blockage of the meibomian glands. Good lid hygiene and hot compresses will help. It is only if they persist that they need surgical removal. They can cause distorted vision if they are very large. Eyelid cysts are very common at any age. Bacteria can enter the eye and we are probably more susceptible due to our silly immune systems and you will be stressed at the moment. Good luck with the thyroidectomy. Poor you, it’s bad enough having one condition without throwing in cancer as well. I’ve had PMR for over three years now and then got breast cancer last year 🙄 Thinking of you 💐

[NanJean]

With + diagnosis of GCA & PMR, I was getting eyelid infections often especially after my eye pressure was checked. While I was on high doses of Prednisone, every cut I got was red & not healing all the way until after I was on an antibiotic by mouth to get rid of the eyelid infections.

I had previously been diagnosed with Blepharitis, but steroids made it 100% worse. My eye doctor recommended Thermalon Dry Eye Moist Heat Compress that you put in the microwave for the chalazion that developed. It got smaller & the compress feels great as long as you heat it about 2 seconds less than the instructions say. I think the steroids make even eyelid skin thinner. But, it only went away when my prednisone was below 10 mg.

Besides washing my eyelids with Lid Wipes, last May I found that using the hand wipes with benzalkonium chloride worked great at keeping the blepharitis under control.

I found online that benzalkonium chloride has worked for many. I'm off steroids since June and still use the wipes 2 times or more a day.

[Janstr]

I've had several blocked tear ducts & styes since being on pred. (I had never had a blocked tear duct before, & had had a very occasional stye ( once every 4 or 5 years) ) & was told by a Dr to put hot compresses on the blocked tear ducts & massage, & if it didnt go away to go to GP maybe for antibiotics. He also told me to buy a product called lid clear from the pharmacy to use daily along with the hot compresses & massage as a preventative. Since doing this I haven't had a reoccurrence.

[Boozsa]

So went to the eye doc and I have cataracts in both eyes and an external cataract(the bump) from Pred, will need surgery. Just going to wait at this point with everything going on. I also tested positive for a gene mutation with the thyroid cancer so my treatment will be even more aggressive now. Thank you all for the responses and advice again. PS my surgeon and ENDO have a plan for prednisone doses during and after surgery for me all set, plus some other things to keep me safe. I feel I am in good hands now and hoping to feel better soon. xoxo boozsa

[PMRpro Ambassador in reply to Boozsa]

All the best. It is mind-boggling when all these things come along at once isn't it. Hugs xx

[Boozsa in reply to PMRpro]

It is. I’m overwhelmed and a little down. My mom will be here next week so I won’t be alone after surgery. It’s been a long journey already and it’s piling up but I’m a fighter and I have this to lift my spirits. Hugs back and I’ll be in touch after surgery for sure I hope you are doing well, I wouldn’t be here without your help and I’m forever grateful.

[Asbeck]

Boozsa: Just wanted to tell you that you have my "good" thoughts, prayers and best wishes.