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Dr. JP
Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience:  Harvard Medical School, Massachussetts Eye and Ear
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Hi, I have really blurry and foggy eye right now. I have this

Customer Question

Hi, I have really blurry and foggy eye right now. I have this simptom a month. My dotor told me that I have a white spot and implammation in back of my eye. He gave me steroid drop, but it is not helpful. How can I find experienced doctors in Los Angeles? What do you think about my eye problem
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. JP replied 4 years ago.

Hi,

 

How long have you had rheumatoid arthritis? Were you diagnsosed as a child?

From you post, correct me if I'm wrong, it seems you have a uveitis? This is either an acute or chronic inflamation inside the eye. Uveitis has a laudry list of diagnoses. Let's try to narrow this down?

 

1. Is it in both eyes?

2. Has this been going on for years, months or days?

3. Is it painful?

4. Does the inflamation alternate eyes?

5. Are your eye's different colors (ie one blue one brown etc)

6. Any medical history of systemic disease like lupus, sarcoidosis?

7. Any recent eye surgery? trauma?

8. Any preceding symptoms or eye findings like conjuctivitis?

9. Have you travelled to areas that are high risk for tick bites, tb exposure etc?

10. Pets at home.. kittens, dogs?

 

Dr. John

Customer: replied 4 years ago.
Thank you for your replay. There are my answers:
1. It starts first in my right eye(2-3 years) and I have implammation in both eyes from last beginning of september
2. Last 3 years. But the implamation comes for 1-2 months then goes 3-4 months. Everytime I used steroid drops when it comes.
3. It's not painful. Very blurry and foggy. Hard to see.
4. My vision gets worse and blurry
5. Colors are same - brown
6. None. Only RA
7. None
8. Can not understand the question
9. No
10. I had a muniture puddle 2 years ago.

Best regards,
Expert:  Dr. JP replied 4 years ago.

I assume you are being treated by an eye physician. Do you happen to know if that eye doctor is a eye inflammation specialist? (they are called Uveitis specialist) I know of at least 5 uveitis specialist in L.A.. Most of them are at Jules Stein UCLA and one is in Orange County area. Do you live closer to UCLA or Orange County?

 

Dr. John

Expert:  Dr. JP replied 4 years ago.
Okay that information helps? Now do you remember if they told you the inflammation was in the front part of the eye (in front of the iris and lens) or in the back of the eye (retina)?
Customer: replied 4 years ago.
The doctor can see white spots in my back of the eye. My front part looks Ok due to steroid drop. Inplamation is back side of eye
Expert:  Dr. JP replied 4 years ago.

Okay, so a posterior uveitis is probable. However I can't be sure as I'd have to see you in the clinic. Anyway, posterior uveitis (inflammation) is typically due to some identifiable cause. I recommend you schedule an appointment with a Uveitis specialist. If you'd like I can recommend one for you. I thorough eye exam by someone whose specialty is in uveitis will be most useful for you. This chronic inflammation needs to be addressed as it can lead more eye problems and eventually harm your vision more. Would you like for me to find a contact for you?

Customer: replied 4 years ago.
Thank you very much. I'd love to see the specialist. Is there any contact address to reach you? What does the white spot mean? Because of the white spot my eye specialist doctor gives me TB medications which are hurt my liver and kidney(last lab test shows). I have hard time with these TB medications. I don't know why am I taking these medications when all test are negative and no result of these medication in my eye. Can you say something. Sorry for asking many questions I'll look forward your refferal.

Best regards,
Erde
(XXX) XXX-XXXX
Expert:  Dr. JP replied 4 years ago.
Below is a Uveitis Questionnaire that you could fill out prior to going to see the Uveitis specialist. This will be most helpful for the physician. Dr. Foster here at Harvard uses it for his patients. The links is at:

http://www.uveitis.org/patient/articles/articles/rev.htmlOcular Inflammatory Disease Review of Systems Questionnaire

C. XXXXX XXXXX, M.D.

This is a confidential survey. Please repond to all questions.

Patient Name:_________________________________________________________

Address: _____________________________________________________________

Telephone Number: _________________________________


Referring Physician: ___________________________________________________

Address: _____________________________________________________________

Telephone Number: _________________________________


FAMILY HISTORY:

These questions refer to your grandparents, parents, aunts, uncles, brothers and sisters, children or grandchildren.

Has anyone in your family had any of the following? PLEASE ANSWER YES or NO.

Cancer
Diabetes
Allergies
Arthritis or rheumatism
Syphilis
Tuberculosis
Sickle cell disease or trait
Lyme disease
Gout


Has anyone in your family had medical problems listed below? PLEASE ANSWER YES or NO.

Eyes
Skin
Kidneys
Lungs
Stomach or bowel
Nervous system or brain

SOCIAL HISTORY:

Age (Years): ________________ Current job: _______________________________

Have you lived outside the U.S.A.?
If yes, where? _______________________________________
Have you ever owned a dog?
Have you every owned a cat?
Have you ever eaten raw meat or uncooked sausage?
Have you ever had unpasteurized milk or cheese?
Have you ever been exposed to sick animals?
Do you drink untreated stream, well or lake water?
Do you smoke cigarettes?
Have you ever used intravenous drugs?
Have you ever had a bisexual or homosexual relationships?
Have you ever taken birth control pills?

PERSONAL MEDICAL HISTORY:

Are you allergic to any medications?
If yes, which medications? _______________________________________________
Please list the medications that you are currently taking, including non-prescription drugs such as aspirin, Advil, antihistamines, etc.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

PAST MEDICAL HISTORY:

Please list all eye operations you have had (including laser surgery), and the dates of the surgeries.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Please list all other operations that you have had and the dates of the surgeries.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Have you ever been told that you have the following conditions? PLEASE ANSWER YES or NO.

Anemia (Low Blood Counts)
Cancer
Diabetes
Hepatitis
High Blood Pressure
Pleurisy
Pneumonia
Ulcers
Herpes (cold sores)
Chicken Pox
Shingles (Zoster)
German Measles (Rubella)
Measles (Rubeola)
Mumps
Chlamydia or Trachoma
Syphilis
Gonorrhea
Any other sexually transmitted disease
Tuberculosis (TB)
Leprosy
Leptospirosis
Lyme Disease
Histoplasmosis
Candida or Moniliasis
Coccidiomycosis
Sporotrichosis
Toxoplasmosis
Toxocariasis
Cysticercosis
Trichinosis
Whipple's Disease
AIDS
Hay Fever
Allergies
Vasculitis
Arthritis
Rheumatoid Arthritis
Lupus (Systemic Lupus Erythematosus)
Scleroderma

Have you ever had any of the following illnesses? PLEASE ANSWER YES or NO.

Reiter's Syndrome
Colitis
Crohn's Disease
Ulcerative Colitis
Behcet's Disease
Sarcoidosis
Ankylosing spondylitis
Erythema Nodosa
Temporal Arteritis
Multiple Sclerosis
Serpiginous Choroidopathy
Fuchs' Heterochoromic Ididocyclitis
Vogt-Koyanagi-Harada Syndrome

Have you had any of the following symptoms in the past year? PLEASE ANSWER YES or NO.

GENERAL HEALTH:

Chills
Fevers (persistent or recurrent)
Night Sweats
Fatigue (tire easily)
Poor Appetite
Unexplained Weight Loss
Do you Feel Sick

HEAD:
Frequent or Severe Headaches
Fainting
Numbness or Tingling in your body
Paralysis in parts of your body
Seizures or Convulsions

EARS:
Hard of Hearing or Deafness
Ringing or Noises in Your Ears
Frequent or Severe Ear Infections
Painful or swollen Ear Lobes

NOSE AND THROAT:
Sores in Your Nose or Mouth
Severe or Recurrent Nosebleeds
Frequent Sneezing
Sinus Trouble
Persistent Hoaresness
Tooth or Gum Infections

SKIN:

Rashes
Skin Sores
Sunburn Easily (Photosensitivity)
White Patches of Skin or Hair
Loss of Hair
Tick or Insect Bites
Painfully Cold Fingers
Severe Itching

RESPIRATORY:

Severe or Frequent Colds
Constant Coughing
Coughing Up Blood
Recent Flu or Viral Infection
Wheezing or Asthma Attacks
Difficulty Breathing

Have you ever had any one of the following symptoms? PLEASE ANSWER YES or NO.

CARDIOVASCULAR:

Chest Pain
Shortness of breath
Swelling of your legs

BLOOD:

Frequent or Easy Bruising
Frequent or East Bleeding
Have you Received Blood Transfusions

GASTROINTESTINAL:

Trouble Swallowing
Diarrhea
Bloody Stools
Stomach Ulcers
Jaundice or Yellow Skin

BONES AND JOINTS:

Stiff Joints
Painful or Swollen Joints
Stiff Lower Back
Back Pain while Sleeping or Awakening
Muscle Aches

GENITOURINARY:

Kidney Problems
Bladder Trouble
Blood in your Urine
Urinary Discharge
Genital Sores or Ulcers
Prostatitis
Testicular Pain

Are you Pregnant?

Do you Plan to be Pregnant in the Future?

 

Expert:  Dr. JP replied 4 years ago.

Since all the test have been negative for TB, then it's unlikely the right diagnosis. I agree with the eye steroid but question using TB medicines without a more confident diagnosis. I recommend either of these physicians.

 

1.

Gary N Holland MD
Member Type:Fellow
Primary Office:Jules Stein Eye Institute
100 Stein Plz UCLA
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN

2.
Ronald E Smith MD
Member Type:Fellow
Primary Office:Ste 5706
1450 San Pablo St
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN (NNN) NNN-NNNN/td>
3.
Ralph D Levinson MD
Member Type:Fellow
Primary Office:Rm 3-124C
100 Stein Plz
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN

 

Wishing all the best.

 

Dr. JP

 

 

Expert:  Dr. JP replied 4 years ago.

I've sent contacts for three physicians, a uveitis inflammation questionnaire for you to fill out prior to seeing them and some comments on the current diagnosis. I hope this helps. I wish I could see you in clinic so I could be more specific. But the diagnosis of eye inflammation is easy. It is the cause that is so difficult to make with out doing blood test such as (ana, rf, ace, lysozyme, lyme titer, vdrl, rpr) and neuroimaging. All these test are based on the evaluation in the clinic.

 

Regards,

 

Dr. JP

Customer: replied 4 years ago.
Please give me your refferal.
Next are my answers.


This is a confidential survey. Please repond to all questions.

Patient Name:_Erdene Tseveen_____________________________________

Address:XXXXX Harbor, CA 90710

Telephone Number: (XXX) XXX-XXXX
Referring Physician: ___________________________________________________

Address: _____________________________________________________________

Telephone Number: _________________________________


FAMILY HISTORY:

These questions refer to your grandparents, parents, aunts, uncles, brothers and sisters, children or grandchildren.

Has anyone in your family had any of the following? PLEASE ANSWER YES or NO.

Cancer Dad - stomack cancer
Diabetes brother -yes
Allergies - no
Arthritis or rheumatism -yes(mom and me)
Syphilis -no
Tuberculosis -no (but I had a contact and treated for 9 months with INH)
Sickle cell disease or trait - no
Lyme disease - no
Gout -no


Has anyone in your family had medical problems listed below? PLEASE ANSWER YES or NO.

Eyes - yes(grandmother)
Skin - no
Kidneys -no
Lungs - no
Stomach or bowel -no
Nervous system or brain - no

SOCIAL HISTORY:

Age (Years): __49____________ Current job: unemployed________________

Have you lived outside the U.S.A.? Yes
If yes, where? __Mongolia, Korea_________________________________
Have you ever owned a dog? Yes
Have you every owned a cat? No
Have you ever eaten raw meat or uncooked sausage? No
Have you ever had unpasteurized milk or cheese? No
Have you ever been exposed to sick animals? no
Do you drink untreated stream, well or lake water? no
Do you smoke cigarettes? no
Have you ever used intravenous drugs? don't know
Have you ever had a bisexual or homosexual relationships? no
Have you ever taken birth control pills? yes

PERSONAL MEDICAL HISTORY:

Are you allergic to any medications? no
If yes, which medications? _______________________________________________
Please list the medications that you are currently taking, including non-prescription drugs such as aspirin, Advil, antihistamines, etc.
TB medication, sulfasalazine, folic acid
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

PAST MEDICAL HISTORY:

Please list all eye operations you have had (including laser surgery), and the dates of the surgeries.

None

Please list all other operations that you have had and the dates of the surgeries.

apendicite, hemoroid

Have you ever been told that you have the following conditions? PLEASE ANSWER YES or NO.

Anemia (Low Blood Counts) Yes
Cancer - no
Diabetes -no
Hepatitis -no
High Blood Pressure -no
Pleurisy -no
Pneumonia -no
Ulcers -no
Herpes (cold sores) -no
Chicken Pox -not sure(may be early childhood)
Shingles (Zoster) -no
German Measles (Rubella) -no
Measles (Rubeola) - no
Mumps -no
Chlamydia or Trachoma -no
Syphilis -no
Gonorrhea -no
Any other sexually transmitted disease -no
Tuberculosis (TB) -no
Leprosy -no
Leptospirosis -no
Lyme Disease - no
Histoplasmosis -no
Candida or Moniliasis -no
Coccidiomycosis- no
Sporotrichosis -no
Toxoplasmosis-no
Toxocariasis -no
Cysticercosis -no
Trichinosis -no
Whipple's Disease-no
AIDS -no
Hay Fever -no
Allergies - no
Vasculitis -no
Arthritis - no
Rheumatoid Arthritis -yes (15 years)
Lupus (Systemic Lupus Erythematosus) -no
Scleroderma -no

Have you ever had any of the following illnesses? PLEASE ANSWER YES or NO.

Reiter's Syndrome no
Colitis no
Crohn's Disease no
Ulcerative Colitis no
Behcet's Disease no
Sarcoidosis no
Ankylosing spondylitis no
Erythema Nodosa no
Temporal Arteritis no
Multiple Sclerosis no
Serpiginous Choroidopathy no
Fuchs' Heterochoromic Ididocyclitis no
Vogt-Koyanagi-Harada Syndrome no

Have you had any of the following symptoms in the past year? PLEASE ANSWER YES or NO.

GENERAL HEALTH:

Chills no
Fevers (persistent or recurrent) yes
Night Sweats no
Fatigue (tire easily) yes
Poor Appetite no
Unexplained Weight Loss no
Do you Feel Sick no

HEAD:
Frequent or Severe Headaches - very severe Headdaches
Fainting - no
Numbness or Tingling in your body - no
Paralysis in parts of your body - no
Seizures or Convulsions - no

EARS:
Hard of Hearing or Deafness - no
Ringing or Noises in Your Ears - no
Frequent or Severe Ear Infections - no
Painful or swollen Ear Lobes - no

NOSE AND THROAT:
Sores in Your Nose or Mouth - no
Severe or Recurrent Nosebleeds -no
Frequent Sneezing -no
Sinus Trouble -no
Persistent Hoaresness -no
Tooth or Gum Infections -no

SKIN:

Rashes - no
Skin Sores -no
Sunburn Easily (Photosensitivity)-no
White Patches of Skin or Hair -no
Loss of Hair -no
Tick or Insect Bites -no
Painfully Cold Fingers -no
Severe Itching -no

RESPIRATORY:

Severe or Frequent Colds -yes
Constant Coughing -no
Coughing Up Blood -no
Recent Flu or Viral Infection - no
Wheezing or Asthma Attacks -no
Difficulty Breathing -no

Have you ever had any one of the following symptoms? PLEASE ANSWER YES or NO.

CARDIOVASCULAR:

Chest Pain - no
Shortness of breath -no
Swelling of your legs -no

BLOOD:

Frequent or Easy Bruising - no
Frequent or East Bleeding - no
Have you Received Blood Transfusions - no

GASTROINTESTINAL:

Trouble Swallowing - no
Diarrhea - no
Bloody Stools -no
Stomach Ulcers -no
Jaundice or Yellow Skin -no

BONES AND JOINTS:

Stiff Joints - yes
Painful or Swollen Joints sometimes, but not right now
Stiff Lower Back -no
Back Pain while Sleeping or Awakening - no
Muscle Aches -no

GENITOURINARY:

Kidney Problems -no
Bladder Trouble -no
Blood in your Urine -no
Urinary Discharge -no
Genital Sores or Ulcers -no
Prostatitis -no
Testicular Pain -no

Are you Pregnant? no

Do you Plan to be Pregnant in the Future? no
Expert:  Dr. JP replied 4 years ago.

Take the completed questionnaire to one of the specialist below. They will be able to render an opinion after a complete examination and necessary test.

 

1.

Gary N Holland MD
Member Type:Fellow
Primary Office:Jules Stein Eye Institute
100 Stein Plz UCLA
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN (NNN) NNN-NNNN

2.

Ronald E Smith MD
Member Type:Fellow
Primary Office:Ste 5706
1450 San Pablo St
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN (NNN) NNN-NNNN (NNN) NNN-NNNN (NNN) NNN-NNNN/td>
3.
Ralph D Levinson MD
Member Type:Fellow
Primary Office:Rm 3-124C
100 Stein Plz
Los Angeles, CANNN-NN-NNNN
Ph: (NNN) NNN-NNNN (NNN) NNN-NNNN

 

Wishing all the best. It's been great chatting with you.

 

Dr. JP

Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience: Harvard Medical School, Massachussetts Eye and Ear
Dr. JP and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
Thank you very much. I really appreciate your help.
Expert:  Dr. JP replied 4 years ago.

It was my pleasure. It is my sincere hope that they can find the cause, and even better improve your visual quality.

 

Dr. JP

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