Uveitis Treatment: Steroids, Side Effects, and Specialist Care - Ophthalmology

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Uveitis, particularly iritis (inflammation of the iris), can be a serious condition that requires careful management. As a patient with ankylosing spondylitis, your risk for uveitis is higher, and it’s important to address any symptoms promptly. Here’s a comprehensive overview of your questions regarding treatment, potential side effects, and the need for specialist care.

1. Do steroids used for iritis cause floaters?
Steroids, particularly when used topically as eye drops, are effective in reducing inflammation in the eye. However, they are not directly responsible for causing floaters. Floaters are typically caused by changes in the vitreous gel of the eye, which can occur naturally with age or due to inflammation. Inflammation itself can lead to changes in the vitreous, resulting in the perception of floaters. If you are experiencing a sudden increase in floaters, it is crucial to report this to your ophthalmologist, as it could indicate a more serious issue, such as retinal detachment.

2. Is steroid treatment the only option for iritis, and are there potential long-term effects?
While corticosteroids are the mainstay treatment for iritis due to their potent anti-inflammatory properties, they are not the only option. Depending on the severity and underlying cause of the uveitis, other treatments may include non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressive agents, or biologics, especially if the uveitis is associated with systemic conditions like ankylosing spondylitis. Long-term use of steroids can lead to side effects such as increased intraocular pressure (which can lead to glaucoma), cataract formation, and potential damage to the retina. Regular follow-up with your eye care provider is essential to monitor for these complications.

3. Should you see a specialist for treatment?
Given your history of ankylosing spondylitis and the recent diagnosis of iritis, it would be prudent to seek care from a specialist, such as a uveitis specialist or a retina specialist. These professionals have advanced training in managing complex cases of eye inflammation and can provide a more comprehensive evaluation and treatment plan. They can also assess whether your iritis is related to your underlying condition and help manage any systemic implications.

In addition to the above, here are some general recommendations for managing your condition:
- Follow-Up Appointments: Regular follow-ups with your ophthalmologist are crucial to monitor the response to treatment and adjust medications as necessary.

- Medication Adherence: Ensure you are taking your medications as prescribed, including any steroid drops and dilating agents. This will help manage inflammation and prevent complications.

- Report New Symptoms: Be vigilant about any new symptoms, such as increased pain, vision changes, or new floaters, and report these to your doctor immediately.

- Protect Your Eyes: Use sunglasses to protect your eyes from bright light, which can exacerbate discomfort during an active inflammatory episode.

In summary, while steroids are a primary treatment for iritis, they are not the only option, and the potential for side effects necessitates careful monitoring. Given your medical history and current symptoms, consulting a specialist would be beneficial for optimal management of your uveitis.