Fuchs' Heterochromic Uveitis

My husband was complaining of increased number of floaters and slight blurred vision in one eye. He went to an opthamologist who diagnosed whim with Fuchs Heterochromic Cyclitits in both eyes.  She stated that there are multiple areas of involvement.  He is treating the symptomatic eye with steroid drops 4 x daily for 3 weeks with a folow up appt in 3 weeks.

Now almost a week later his MD calls and states that she has been discussing his case with her collegues and determined that this is not a typical presentation as there is "too much inflammation in the eye". and has referred him to a Retinal specialist who we can't get in with til early December.  She mentioned the name of another diagnosis to him, but all he remembers of it is "-itis"  I have a call out to his Dr. to clarify what she is thinking.  But while waiting for a response I am driving myself crazy.  I am a nurse so I am finding that my limited knowledge in this specialty is frightening.  

My husband is 35 years old, otherwise healthy, as far as we know.

Any clues as to what we might be looking at?

[Michael J Kutryb, MD]

You know, I was doubting the diagnosis of fuch's heterochromic iridocyclitis because it is often fairly mild and just in one eye.  He doesn't fit the classic profile either.  Anyway, there is obviously a significant degree of uveitis present in the front part of the eye (anterior uveitis) and some in the vitreous and pars plana (intermediate uveitis) but apparantly not in the chorioid (posterior uveitis).  The possible causes are quite numerous and a medical workup will likely be undertaken.  A definitive cause can only be found about half of the time or less.  Treatment often involves steroids either as a drop or injections and sometimes even systemic steroids or rarely other anti-inflammatory or immune suppressing drugs.  Sometimes rare, treatable infections like lyme disease or tb can be treated as a cause.  As a side note, I have read of some cases recently that were due to lyme disease and encephalitis. - just a  few possible causes among so many.
MJK MD

[KathyRN218]

Just wanted to add an update - the new condition he has been diagnosed with is Pars Planitis.  Any info on this disease would be welcomed!!

[Sandy Feldman, MD, MS]

Dear KathyRN218,

It sounds as if your husband has inflammation in the back of the eye in a region known as pars plana, which is at the very edge of the retina.  Possible causes of this include idiopathic [or unknown], sarcoid, Lyme’s disease, multiple sclerosis or cat scratch fever.  I would recommend that you seek the care of a retinal specialist or uveitis specialist to determine the cause and treatment plan.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[KathyRN218]

We have an appointment on Dec 3rd with a Retinal Specialist, and in the meantime he is using the steroid drops 6 x daily.  After just 1 week of using drops the number of floaters has decreased and the blurryness has resolved.  So even though I am panicking and imagining the worst, I am hopeful for a good prognosis.

Thanks for the information and I will post updates as we learn them.  

Any thoughts on what to expect for treatment options and long term prognosis would be appreciated.

Thanx again - Kathy