My 11 year old daugther was diagnosed with JIA when she was one. She has been on MTX for quite a while (dosing being adjusted now and then), and hasn't had
a flare in over a year. However, on her routinary visit to her ped. oph. a year ago, she was diagnosed with anterior uveitis on both eyes, being the left eye,
the most affected. She was initiated on Pred Forte 4x daily, and for the first few months, it seemed to be improving all along (the right eye was
'clear') until she was taken off the drops. Unfortunately, 4 months ago, her uveitis had progressed, and the rheum wants to start my kid on Humira
along with methrotexate. Honestly I am not thrilled about it, as I wasn't on Enbrel. The JIA is well under control...now almost all the visits are to the
ped. oph, who I must admit is very good, but immunology-wise, her expertise falls short, and seems to be too conservative.Based on that, I have a few
questions:
1) For how long can Pred Forte be used w/o the related complications? I mean, once it is been tapered, how many times can she go back to the drops? Are steroid injections an option for my daughter?
2) The ped oph says that my child's uveitis is not 'bad', yet the inflammation is still a concern, that it seems to be 'stagnant'...is that good enough, or better said 'wise observation' by a clinician? Guess the comment came from my question on the previous evaluation vs the evaluation she was doing that day.
3) I have reviewed all of the posts on this forum, and one caught my attention: the use of an NSAID along with Methotrexate and topical steroid (Pred Forte)...is that corrrect? She has been on other eye drops like Lotemax 4xdaily, but no progress has been achieved with this drug.
4) I couldn't find a specialist on occular immunology and uveitis on your list with practice in Puerto Rico, where I live. However, I did find one on the local yellow pages, but how can I trust that he has had the right training/expertise? Are there any of these specialists in the Orlando, FLA Area? My sister lives there and it is fairly close to Puerto Rico.
Last, but not least, keep up with this excellent site. I have learned a lot about uveitis due to the resources you have posted. I will appreciate your response to the questions above, that may seem 'silly', but not for a mother that is desperately looking for the welfare of her beloved daughter.
Mrs. Helga Lespier from San Juan, Puerto Rico
1) For how long can Pred Forte be used w/o the related complications? I mean, once it is been tapered, how many times can she go back to the drops? Are steroid injections an option for my daughter?
2) The ped oph says that my child's uveitis is not 'bad', yet the inflammation is still a concern, that it seems to be 'stagnant'...is that good enough, or better said 'wise observation' by a clinician? Guess the comment came from my question on the previous evaluation vs the evaluation she was doing that day.
3) I have reviewed all of the posts on this forum, and one caught my attention: the use of an NSAID along with Methotrexate and topical steroid (Pred Forte)...is that corrrect? She has been on other eye drops like Lotemax 4xdaily, but no progress has been achieved with this drug.
4) I couldn't find a specialist on occular immunology and uveitis on your list with practice in Puerto Rico, where I live. However, I did find one on the local yellow pages, but how can I trust that he has had the right training/expertise? Are there any of these specialists in the Orlando, FLA Area? My sister lives there and it is fairly close to Puerto Rico.
Last, but not least, keep up with this excellent site. I have learned a lot about uveitis due to the resources you have posted. I will appreciate your response to the questions above, that may seem 'silly', but not for a mother that is desperately looking for the welfare of her beloved daughter.
Mrs. Helga Lespier from San Juan, Puerto Rico
