Uvitis when tapering prednisone

[spacevoyager]

My eyes became very sore a month ago, on Christmas day actually. I had headaches around my eyes. They were very red and stingy. There was no discharge or stickiness like you get with conjunctivitis. Nonetheless, I was diagnosed with viral conjunctivitis by a GP. The condition got better but I still have blurry vision and my eyes are light sensitive.

Today I was examined by a proper optometrist. He said that I do not have conjunctivitis, but rather I have Uvitis., ocular inflammation. Then he explained that it happens in patients with PMR and happens more when tapering the Predinisone. I have been tapering for a couple years, from 20mg to 2.5 right now. No other symptoms of PMR at the moment.

He showed my this study (hope the link works) Although I do not have accress to the full article. tandfonline.com/doi/full/10...

I don't have access to the full article but read the summary of the study. Upon further looking, I found many studies about concurrent conditions of PMR and Uvitis.

The optometrist said my condition has stabilized, so that's good. And hopefully it will go away eventually.

Anyone have experience with this condition?

[Wouldlovetorun]

Hello spacevoyagerI hope you make a speedy recovery.

Thank you for sharing the link and telling us about the connection with tapering pred. I didn't know about this.

Its a v unpleasant thing to have.

I have had it quite a number of times but not had a flare in years. If ever I am concerned about the beginning of a flare I got to my optician and get it checked.

You have done very well tapering to 2.5mg🙂

Get better soon.

x

[Orange_2022]

I've had a few instances of my eyes feeling as if I needed to blink a lot to clear them. They've been pink and I had a slight stye once. Sometimes a bit crusty in the mornings too. My vision is definitely worse in the last 6 months too. Maybe it's uvitis! Never heard of it before...no end to the interesting side effects of pred/PMR! 🙂Thanks for your post - something to look into although mine comes and goes and I'm having regular eye checks.

[waltztherapy]

I have just been diagnosed with blepharitis, eyes not red, just runny and sticky at times. Prescribed 'dry eye' drops which do help. Thought it was caused by the aftermath of two cataract surgeries, one in July and the second end of October. But now believe it might be associated with PMR. This kind of stickiness, used to feel like excema in the eyes, so the usual inflammation response I guess, similar to rosacea. I avoid those well known dietary triggers, but agree with advice on still needing steroids for the PMR. I am currently stuck at 6.5 mg prednisolone with a persistent flare up of varying intensity. 'Toughing it out' for now, grateful that I'm managing to do my usual exercise activities (dancing, table tennis and walking) with limitations, when I hit the 'brick wall' etc. Good luck to all with tapering minefield.

[PMRpro Ambassador in reply to waltztherapy]

Blepharitis can be well managed using scrupulous eyelid cleaning procedures. People will tell you theirs if you post about it in a new thread.

[waltztherapy in reply to PMRpro]

Thank you for your kind reply.Much appreciated.

[DorsetLady PMRGCAuk volunteer in reply to waltztherapy]

These might help - used twice a day initially for 4 weeks, then reduced to once a day,.. and then as and when necessary. But continue to use eye drops generously according to optometrist ..

Eye mask/wipes

[waltztherapy in reply to DorsetLady]

Thankyou so much for your kind advice.It's so much appreciated.

[PMRpro Ambassador]

The conclusion says "inflammation was OFTEN bilateral" - in a sample of THREE cases. They also say it is "relatively uncommon". Couple of non-seqitors there!

Uveitis is common in certain forms of inflammatory arthritis - which are relatively often confused with PMR in diagnosis. In all the years I have been on the forums there have been only a few cases amongst members and some of them have been in patients who also have or may have inflammatory arthritis.

In the UK, anyone with eye symptoms is best to go to the local optometrist offering the MECS or CUES services. They have been set up to provide an eye ED/A&E option locally

primaryeyecare.co.uk/servic...

primaryeyecare.co.uk/servic...

Even EDs rarely have the equipment to examine eyes fully and GPs certainly don't. The opticians services are highly skilled and highly equipped.

[spacevoyager in reply to PMRpro]

Thanks for your reply PMRpro! I am in Canada and don't think we have eye clinics here. But the optometrist I saw yesterday is now on my radar and I can always go back to him. I do have osteoarthritis, so yes, inflammation elsewhere in the body. Too bad I didn't know to go to an optometrist right away and hence the conjunctivitis diagnosis 4 weeks ago.

[Rancho]

Hi spacevoyager, I was diagnosed with PMR in 2009 and then with GCA in 2014 following double vision. GCA turned out to be the wrong diagnosis as in 2018 I was diagnosed with ocular myasthenia gravis.

I’ve been on a prednisolone rollercoaster over the years but over last 2 years have tapered like you from 20mg to current 3mg. I’ve also been taking 15mg methotrexate weekly for the past 2 years to help pred tapering.

A few months ago I got red eye, soreness and a gritty feeling but no discharge. The eye hospital said conjunctivitis and gave me eye drops, it came back and got same diagnosis and treatment a second time.

Now waiting for a third appointment and you post is timely as I will highlight the pmr/inflammatory eye issue with them.

Hope your condition improves soon.

[spacevoyager in reply to Rancho]

Thanks for your reply Rancho! There are so many auto immune conditions! The worse thing for me was the eye headaches at night and the light sensitivity making it impossible to drive or go outside. It almost gone now thank goodness.

[Koalajane]

I don’t have uvitis but have macular oedema which has been treated for the last 3 years. I often wonder if it is really diabetic as have been in diabetic remission for 6 years. So I wonder if it is something to do with PMR but the main thing is it is being treated.

[spacevoyager in reply to Koalajane]

Thanks for your reply. I am learning for all this that there are so many eye conditions. And I will take the eye checkups more seriously especially as I age. Good luck with your treatment.

[Rosiecavapoo]

Hi, I have had Uveitis many times. Such a painful condition. Symptoms include red blood shot eyes, blurry vision, sensitivity to light and of course the pain.

Confirming what PMRpro said my Uveitis was a side symptom of Ankylosing Spondylitis . The only place you can go for diagnosis and treatment is a Eye A+E department as they are equipped to treat you.

Thank you for your post and link

[spacevoyager in reply to Rosiecavapoo]

Thanks for your reply. Yes. Those are the symptoms I had. How did they treat your condition?

[Rosiecavapoo in reply to spacevoyager]

Treatment was Steriod eyes drops every 2 to 4 hours depending on severity. The treatment lasts at least a month maybe longer. If you stop the treatment too early it will all come flooding back.

It can be very persistent and you can get another flare up months after treatment ends.

But as soon as you apply the drops all the pain and symptoms go away. But you’ll be reminded if you stop the drops!

[spacevoyager in reply to Rosiecavapoo]

Thanks. I will try to get some to keep on hand.

[howtotaperdown]

yes I had uvitis 6 months prior to having PMR (although PMR might have been creeping up on me in those 6 months) it was treated with steroid eye drops and now a couple of years later some symptoms have come back with a heavy Xmas cold/virus.... altho my now friendly 'eye clinic/optician' said it was just dry eye syndrome... it is worth finding an eye clinic, they are usually opticians who have the equipment and trained staff member, and are funded by your NHS GP, but it avoids the trip to the eye hospital.

I didnt know it was more likely with tapering pred, as I had it before pred, but now tapering once again - got to 7mg but suffering some - and having caught a virus leaving me with sore eyes, I have booked a 'tear flow test' tomorrow which checks out tear ducts etc and might hopefully give me some info or better eye drops! I'll post if I find this test very useful (£80 in my eye clinic in London; an hour and includes a follow up test 2 months later) the optician also felt that warm mask shown by Dorset Lady might help, but will tell me tomorrow

[spacevoyager in reply to howtotaperdown]

Thanks for your reply. I am in Canada and we don't have eye clinics here...just private practices. PMRpro said in her reply that getting Uvitis while tapering pred is rare, so maybe that's just a fluke. Good luck with your test and wishing you a speedy recovery!

[howtotaperdown]

thanks and good luck with yours too.... and although there doesnt seem much relationship between the conditions I wonder if it wasnt part of the slippery slope of auto-immune problems (for me)... also of course it makes me very mindful of GCA...