Iritis

[Wilderman]

Hello,

I have iritis.  I am a Canadian missionary living in Papua New Guinea with the nearest eye specialist, optomologist an hour flight away. Since I have had it before I am providing self treatment with (at least one outdated) med: (1) I am treating myself with something I picked up here called Maxidex (Dexamethason .1% with other ingredients including Benzalkonium Chloride .001%, Hydroxyphropl Methylcellulose .5%) and I am wondering if that will help cure it?  I don't have access to prednisolone which I have used in the past.  (2) I have had it for two weeks now, and with the Maxidex I am treating myself with a  very outdated (2 years) eye dialator called isopto-homatropine 5%every other day?  Can you make any recommendations! Thank you kindly for your help!!  Ian      

[Wilderman]

Thank you kindly for your answer!  I keep the meds refrigerated due to the fact that we are 4% below the equator.   Your point on the prednisolone may explain why it is taking longer to heal this time than the three times before.  I put an order in for prednisolone but it has to come up from Australia...hopefully I can get my hands on it soon.  

Question:  I have a bit of prednisolone left, can I apply both during the course of a day?  

If it doesn't heal by next week Wednesday (three weeks) I will fly to the capital, Port Moresby and search out a ophthalmologist there.  

Thank again...very much appreciated!  Thanks

[Ray T Oyakawa, MD]

Maxidex is a steroid that does not penetrate as well as prednisolone.  The two year old drops should be ok is stored at room temperature or better if refrigerated.  I would first try the Maxidex for a few days and if have discomfort or pain add the homatropine.

You should not continue the drops for more than three weeks due to the risk of glaucoma and cataracts.  It is best to see the ophthalmologist.

Dr. O.