Dr. Vaibhev Mittal
Ophthalmology (Eye Care)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I was diagnosed with bilateral anterior uveitis two months back. I was put on Pred Forte. After 20 days of which only occasional AC cells were seen in right eye with no flare. Left eye was clear, but few mid vitreous cells were seen which were not present before. Hence, I was still on Pred Forte 2 times a day. A month back few vitreous cells were seen in right and left eye with no vitritis, no intraocular infection and no AC inflammation. Hence, everything was stopped. But, when I went again to the doctor, the following were the findings of my right eye. 1+ vitreous cell, with stable inflammation and shoe horse tear with minimal elevation which got treated by barrage laser. In left eye, there were traces of vitreous cells with no vitritis. Pred Forte was advised every fourth hourly for right eye. Can these vitreous cells be caused by anterior uveitis itself? As according to my doctor, I do not have vitritis too and I am consulting a uveitis specialist? Should I continue Pred Forte till all vitreous cells go away? Kindly help.
Hi,
Welcome to icliniq.com.
I think you have anterior uveitis in both eyes. Few vitreous cells can be present in anterior uveitis patient also. Usually, anterior uveitis is in one eye, but if bilateral we investigate them as it was done in your case. So, now you are HLA B27 positive (human leukocyte antigen). We usually treat patient with topical steroids if only anterior uveitis is there. Horse shoe tear was an incidental finding which was managed appropriately. To my opinion you are being treated adequately and efficiently. For vitreous cells we do not treat until and unless vision drops to less than 6/12.I hope this helps you.Regards.
Patient's Query
Hi doctor,
Thanks for the reply.
The reason for this confusion is that I got my retinal tear treated by a retina specialist as advised by my doctor. The strange part is that he had written panuveitis in the right eye. I am confused whether I have intermediate and posterior uvietis too. When I reached my uveitis specialist he said that is not the case. Please clarify my doubt.
Hi,
Welcome back to icliniq.com.
Panuveitis means combination of anterior, intermediate and posterior uveitis. As you mentioned you have HLA B27 related uveitis, it is more common in anterior segment. Posterior segment involvement is rare. As I told you earlier, few vitreous cells are common in anterior uveitis, but that does not mean that you have intermediate uveitis. Moreover, guidelines suggest that for initiating treatment for intermediate uveitis (systemic steroids/sub-tenon injection) vision should be less than 6/12. If you are consulting with a uveitis specialist then I would suggest you to stick with the opinion of uveitis expert. I hope this helps you. Regards.
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Ophthalmology (Eye Care)
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