Hello and thanks for your question. You have done a good job detailing your history and I believe you have provided me with as complete a picture as possible without me being able to examine your eyes, see the other measurements in your chart, or study your visual field reports.
Your history of eye problems sounds quite difficult and the prospects for future eye problems quite harrowing. I have treated numerous patients with very similar clinical courses to yours and if there's one thing I've learned through treating these patients it is that no two patients have the same result, clinical course, or severity of symptoms.
In light of this, I would have to say that depending on how advanced your visual field loss is and in correlate, how much damage your optic nerve has sustained, will likely be the main determining factor in if / when you go blind. Not knowing the specifics of these details, it would be difficult for me to even give you a general idea of what your prognosis might be. I will say, though, that the speed with which you may be suffering visual field loss and optic nerve damage can often be used as surrogate prognostic factor. If there has been significant and rapid visual field loss, then this portends a more likely course to blindness.
On the opposite side, however, of the many people like yourself whom I have treated, almost all of them are able to achieve a quiet enough stage in their uveitis that they can have their cataracts taken out and this contributes a tremendous amount to their visual recovery. There are also newer steroids such as Durezol and also newer ways to deliver steroids than ever before. In addition, many of these patients are also successfully controlled on steroid-sparing agents such as the methotrexate you are on. Because of the success for most of these patients that I've treated, I would also expect that you, too, are likely to achieve a baseline level of inflammation suppression that may hopefully stave off further vision loss. Many patients as they get past the age of 60 see that their uveitis tends to weaken to the point that it does not continue to cause further active inflammation, enabling problems like their glaucoma and/or retinal edema to be more successfully treated.
While doing cataract surgery in your case is risky, so is losing your vision risky to your overall life expectancy. In my mind, every effort should be done to enable you to undergo cataract surgery, even if it means an aggressive treatment plan to get your eyes quiet prior to the surgery. If there is one thing I've learned as an ophthalmologist, it is that when people lose significant vision, even in just one eye, their quality of life declines to the point that it can hasten depression and dementia, which in turn can actually shorten their life expectancy. Maintaining as active and healthy a lifestyle as possible throughout your eye problems will do much to stave this off, but just as important as this is retaining your vision.
Knowing what I know about you, do I think you will go blind (meaning vision worse than 20/200 or a visual field constricted to less than 10 degrees in either eye)? I think the odds of this happening in one eye are not small. However, I think your odds of maintaining useful vision in one and/or both eyes are even greater.
I wish I could give you some percentages of rates of blindness from research studies, but there are no large-scale, randomized, double-masked, controlled studies elaborating on the rates of visual acuity loss and/or visual field loss in chronic uveitis. In addition, even if there were, the course of chronic uveitis is so different for everybody, especially given the different causes and the different patient factors that affect the clinical course of uveitis (patient age, overall health prior to onset, lifestyles, etc.).
I hope that's been helpful. If you have other questions or want some clarification from my comments I'd be happy to continue to provide them to you at your request.
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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.