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LASIK in Uveitis Patient
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LASIK in Uveitis Patient

I am a 29-year-old with idopathic bilaterial anterior uveitis.  I was diagnosed when I went to the optometrist for a routine exam to have my contact lens prescription renewed, and had been completely asymptomatic.  The ophthalmologist put me on Pred Forte and tapered me off of it over the course of about 3 weeks.  The cells cleared up quickly, and my eyes remained clear until I was taken off the Pred Forte completely, at which point it returned, although at a much lower level than when I was initially diagnosed.  He then put me back on the Pred Forte and tapered me off again, this time over the course of about 3 months.  Again, the inflammation cleared up immediately and my eyes remained clear throughout the taper, until we stopped the Pred Forte completely.  After that, he decided to put me back on the Pred Forte, taper me down to 1 drop per day, and to keep me at that level for the foreseeable future.  I have been on 1 drop/day of Pred Forte for about 4 months now

My question is regarding laser vision correction.  Faced with the prospect of not being able to wear my contact lenses for an extended period of time, I would like to have my vision corrected surgically.  I was wondering if this would be possible.  My thinking is that it might be possible to take me off of the Pred Forte and then have the surgery, assuming I could then go back on the steroid to retreat the uveitis afterwards.  Would my eyes have to be clear at the time of surgery?  I imagine that the inflammation will return once I am taken off the Pred Forte - if so, will that prevent me from being able to have the surgery?  Or could the LASIK be performed even if I had some low level of inflammation, assuming we would resume the Pred Forte to control the uveitis afterwards?  Or do I have to go off the Pred Forte, hope it doesn't flare back up, and schedule the surgery if my eyes manage to stay clear for X amount of time?  

I would appreciate any thoughts you have!
Tags: LASIK, uveitis
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Remaining on predforte indefinitely, even at one drop a day, sets you up for cataract at a young age and also glaucoma.  You might be better off on a systemic medication such as methotrexate.  With such persistent, bilateral uveitis it is worth doing some basic blood tests to see if there is an underlying cause, such as rheumatoid arthritis (even if you have no other symptoms yet).

Uveitis alone is not a contraindication to wearing contact lenses.  So these two issues do not follow.

Your situation sounds a little confused to me.  You should seek an opinion from an Eye MD (find one at www.aao.org).

If you were my family member, I would tell you NOT to have refractive surgery until your uveitis was properly diagnosed and fully controlled.  Uveitis can make you blind.
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John C Hagan III, MD, FACS, FAAOBlank
Discover Vision Centers of Kansas City
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