Q. After using eye drops for scleritis, I had partial vision loss. Why?

Answered by
Dr. Manjunath Natarajan
and medically reviewed by Dr. Vinodhini. J
Published on Jan 05, 2020

Hello doctor,

I saw an ophthalmologist for what I thought was a pink eye infection. The following issues were addressed:

Acute (sudden onset) inflammation of the conjunctiva (the membrane that covers the white part of the eye) causing the white part of the eye to become red and irritated with the formation of little bumps inside of the inner eyelid and misalignment of the eyelashes which rub against the eyeball causing irritation. His diagnosis was some type of scleritis. He wrote a prescription for drops with an antibiotic and told me to give it a few weeks to clear up and nothing serious.

Within a month there was little marked improvement so I went to see him again. He was amazed that there was no improvement and laughed. He said all of my patients get better with this medicine except you. You should probably check with the pharmacy and see if this was a bad batch. Maybe it got too hot on the truck. I was literally taken back.

He took me off of that medicine and told me to get over the counter drops similar to No More Tears, I did and used for one more week with no improvement. I called his nurse at his office and he prescribed Prednisolone acetate drops which did seem to eliminate the white blisters on the white of my eye. However, my eye started to hurt as if someone was stabbing it with a needle over and over at random times. By the next day morning, I lost a part of my vision in my left eye. It was as if someone smeared my lens with vaseline, blurry and looked like I was looking through frosted glass, and also painful. I called his office and he was on vacation so they referred me to the physician on call at another facility. The doctor was shocked that this had gone on for so long. He was afraid my vision was in danger because of nontreatment. He diagnosed me with dendritic keratitis and shingles of the eye (cornea).

He did not want me going back to the previous doctor. I have been with him since trying to get this fixed. He prescribed me the shingles medicine Valtrex. The shingles in the eye are getting better now but the damage which could have been prevented has taken its toll. My left eye is left with a smear, haziness, fog or frost vision which makes it impossible to focus especially with both eyes open. I asked him about a possible cornea transplant and he said the damage was likely too deep in the eye to make a difference. In fact, that could even make it worse. Is this true?

I now see two blurry red light traffic signals covered in frost or haze. He said the haze would be permanent. My wife and I are almost retired and wanted to travel before this happened. Please let me know what I can do in this matter or any surgical recommendations? The prognosis for full recovery was bleak when talking to another doctor.

Dr. Manjunath Natarajan

Ophthalmology (Eye Care)
#

Hello,

Welcome to icliniq.com.

After going through your history, I understand that you have two concerns. Firstly, what has gone wrong and the second is how to fix it?

From what you have mentioned in your query, I can tell that you have at least two problems interfering with your vision. 1. Corneal scarring due to the viral infection of the cornea. This is an end-stage and can be corrected using a corneal transplant. Although the information you have provided is quite detailed, it would be useful to have a photo of your cornea (the round black part of your eye). This is to check for corneal ulcers or scarring.

2. Optic disc damage or glaucoma, I think this may be present as well, it is a common side effect of long term Prednisone and probably why your second doctor said that a corneal transplant will make this worse as the problem is too deep in the eye.

Once again, although your description is detailed, glaucoma cannot be ruled out by this limited information. Please send a photo of your doctors reports or at least the intraocular pressure readings.

Coming to the cure, corneal scarring can be cured with a corneal transplant. But I am afraid if you have glaucoma, there is no way to get back the vision you lost. All we can hope to achieve is not to let further damage to the disc happen.

I hope this helps.


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