Thursday, April 10, 2014

My eyes, my eyes! Travails of progressive bifocals, the eye doc...and cataracts?!

Saw eye doc yesterday. Terribly necessary because I cannot see anything in focus in any field of my progressive bifocals at this point; things are fuzzy, and for close up (like reading a pill bottle), I just take my glasses off or lift them up. It's incredibly annoying.

Good news/bad news. Good news first - no damage from taking Plaquenil (rheumatoid arthritis drug), or any sign of diabetic retinopathy. She was shocked since I've had insulin-dependent diabetes for ~30 years at this point -- I keep my BGs in line, that's why! [Eyes fine; legs/feet and neuropathy not so much.]

My prescription at this point has changed (no shock there), but the other element at work is that because of RA and some of my meds, my eyes are extremely dry, so much so that the doc said I need to come back next week. I have to use eye drops every 4 hours and eye ointment at night. Then I'll come back retest and see if the script matches my tests yesterday. Some info:

Dry eyes is a common problem for patients living with rheumatoid arthritis. Patients may notice irritation, a gritty feeling, painful burning, sensitivity to light, and a sensation that something is in the eye. It is caused by a lack of tear production. Patients with dry eyes are at increased risk for infections around the eye and damage to the cornea. 
Eye dryness is also a symptom of Sjögren's syndrome which is an inflammatory disease that can affect many different parts of the body, but most often affects the tear and saliva glands. Approximately 10 to 25 percent of rheumatoid arthritis patients will develop Sjögren's syndrome. Treatment for dry eyes include artificial tears or prescription eye drops (ie. Restasis).
We'll see how things go in a week. On the matter of the actual glasses, I don't know if I just need to pick my battles and trash the whole progressive bifocals thing.

Oh yeah, the bad news -- she was shocked to see that I'm developing cataracts in BOTH eyes. She was like -- "wait, you're too young for cataracts at this stage!" (I'm 50) Last year there was no sign of this, but yet again, inflammation from very active RA can play a role. So I have to stay out of the sun, keep blood glucose numbers (BG) in line and stay away from prednisone (a steroid many RA patients rely on for some relief; I don't use it because it screws up my BGs). Thankfully I don't smoke, another factor in developing cataracts.

It also explains why night driving has become more difficult, and why bright light has been hurting my eyes more than in the past.

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