Redness in eyes, epi-scleritis, then scleritis, then optic neuritis

[bob mues]

49 yr old male, good health, recently having eye problems. Started w/ redness in left eye, then right 1 wk after trip to Caribbean 6 mo. ago. Wks later started getting severe pain. Diagnosed with epi-scleritis. Prednisone drops didn’t help, pain got worse. Ophthalmologist said I had scleritis. Blood tests for auto-immune causes revealed no problems. After 3 mo. w/redness/pain 2 steroid injections (1 wk apart) were done in  right eye  Redness/pain went away in right eye, but started getting blurring in right eye days after 2nd injection. MRI revealed neither systematic problem nor MS. Staff optic neurologist said case was rare; concluded severe swelling may have pinched arteries supplying blood to optic nerve, he had nothing to offer. Second opinion confirmed optic neuritis. Was put on IV & prednisone (oral). No improvement in right eye but redness in left went away. VER test confirmed optic neuritis. Retina specialist affirmed diagnosis but indicated dangerous to inject steroids directly in white of eye. Now redness/pain again bothering left eye. Doctors say it’s epi-sceritis; taking prednisone drops (2 weeks), no improvement; also using non-steroid drops (AcularLS) & endomethacin. Consensus is case is idiopathic. Could steroid injections damage optic nerve? Coincidental occurrence of optic neuritis after 2nd injection? Could I have infectious/viral cause? Is it normal to have some discomfort with the optic neuritis after 7 wks? Optic neurologist says swelling gone down. Is it unusual for episcleritis re-appear (left eye) after IV / prednisone treatment?  Suggestions?

[nin77ca]

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