Eye Biopsy

[ISABEL12]

Has anyone suffering from WG'S had an eye biopsy? If so how long do you stay in the day unit for and whats involved in the procedure?

[Murfdom]

Hi Isabel

I had a biopsy undertaken at Moorfield's Eye Hospital in London in November 2011. This was obviously before my final diagnosis of WG. My operation was undertaken at 09.30 and I was able to leave at 21.00 with an accompanying adult one my condition had been assessed.

The incision was made under my right eye to gain access to the rear of the right orbit where the biopsy was taken. In my case, they found a large lump, which was removed. Post operation, the eyelid was kept from opening with a Frost suture and the front padded and taped quite tightly. This remained on for a week. I felt no pain post op but the Frost Suture was annoying for the week it was in place ( had it removed a week later at my local hospital eye unit a week after the operation and the stiches under my right eye removed there a week after that). The tip of my nose on the right side and part of the cheek under the right eye were numb post op but this improved over time ( it can take a year for the nerves to recover fully). I was placed on a massive dose of Pred immediately which reduced to 10mg/ day after 12 days. This was maintained until I had my post op interview a month after the procedure where it was confirmed that I had WG. I was referred to my local hospital Rhematology Unit for future monitoring and treatment of the condition.

The incision under the eye has faded to a thin line now, only noticable up close.

Don't worry unduly about the biopsy procedure ( remember to drink plenty of water as soon as you can after the op - you will be dehydrated! I drank gallons!)

[John_Mills Volunteer]

Hi Isabel,

I have never heard of anybody with WG having an eye biopsy - but that doesn't mean that it is exceptional. The technique is used for other purposes such as investigating a possible tumour behind the eye.

There can be various problems affecting the eye associated with WG and with steroid treatment (which can cause cataracts). Sometimes it is investigation into eye problems that lead to a diagnosis of WG.

WG and other inflammatory diseases can cause scleritis or episcleritis, which is inflammation of the coating of the eyeball. The formation of granulomatous tissue behind the eyeball can push the eyeball outwards, stretching the optic nerve, so this is serious and maybe the reason for the biopsy.

The optic nerve itself can rarely be affected by the vasculitis process, so it can sometimes be necessary to take a small biopsy of the nerve to establish if it is damaged.

I see that whilst I have been writing this, someone has given a very full response to your question and I think it sounds very reassuring. It's certainly increased my knowledge of the subject, so I'm very grateful and it does show how valuable this site is for sharing knowledge and experience.

John