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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hello, I have been treated with Pred-Forte eye drops for several

Resolved Question:

Hello, I have been treated with Pred-Forte eye drops for several years for iritis which stems from having a flare-up of when I had shingles on my face. This eye is drier than the other and I'm also on Restasis. Last summer when I saw my eye MD he says I now have a cataract.
I've searched online for aloe vera eyedrops since aloe vera is healing and I even saw a patent for aloe vera eyedrops. But I can't seem to find any online. I need to find something to heal the inflammation not just keep it from getting worse. Any ideas?
Thank you.
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Unfortunately, cataract formation is a know side effect of prolonged steroid use.

Dr. Rick :

Obviously you have rather serious bouts of iritis which, it seems, you have been able to control with the use of only topical steroids. That is a very fortunate thing indeed.....many patients with your condition are not so lucky.

Dr. Rick :

So. Let me make sure I understand you. You would like to replace your topical steroids with some other, hopefully homeopathic compound such as aloe vera eye drops, so as to reduce your incidence of unwanted effects such as cataract. Is that correct?

Customer:

Basically, yes but the immediate problem is the iritis and accompanying dryness.

Customer:

If the iris can heal I would think the steroid drops could be stopped unless there's another flare-up of the virus. I do have some post-herpetic itching sometimes on my forhead and also on the edge of the eyelid.

Dr. Rick :

OK. I understand that you would like to get to the root of your iritis and cure it once and for all instead of just treating the "symptoms" which is the inflammation/dryness in your eyes. Is that what you mean?

Customer:

If that is possible. I just don't know if the virus will flare up in the future but I'm trying to improve my health and stress level. Is there such a homeopathic compound to heal the iritis and not just treat the symptoms?

Customer:

Also, I thought about going to an acupuncturist who might be able to calm the "nerves" related to the eye as I understand that the shingles virus follows a nerve path.

Customer:

Its sort of a 2 fold problem but yes, the iritis is what Im really asking about.

Dr. Rick :

As a retina specialist I treat a large number of patients with various types of ocular inflammation. I completely understand your desire to find some homeopathic compound to get to the "root" cause of your inflammation in a healthy way that doesn't cause all these problems. I can tell you that, after almost two decades of treating ocular inflammation, no such beast exists.

Dr. Rick :

While it is true that shingles travels along nerves it doesn't work that way....I would not risk blindness by switching to acupuncture to cure your iritis.....

Dr. Rick :

I've had this conversation with a number of patients over the years and I do understand what you are wanting to do......I'm sorry to say that it is not possible. Oh sure, if you look hard enough you will find a "doctor" etc who will tell you that they can give you what you want but, in the end, you will just end up having less money in your pocket and be left dealing with the, sometimes irreversible, damage caused to your eye during the time you were off the medicines (steroids etc) that work.

Dr. Rick :

I know this is not what you want to hear but I can't in all good conscience encourage you to pursue the treatment options you are looking for........

Customer:

I certainly wouldn't go off the steroids unless something else was helping but I wonder if I can try other things along with the steroids. It seems odd that the eye can't heal itself since other parts of our bodies can. Would there be any harm in using a dilute solution of aloe vera juice and water as an eye drop?

Dr. Rick :

No. There would not be any harm at all in using those drops as long as you wait for at least 5 minutes after putting in your Pred Forte drops so as not to wash it out.

Customer:

Can you explain to my why in laymen's terms why the inflammation doesn't heal with time?

Dr. Rick :

Actually, in the case of the type of inflammation you have related to a prior shingles attack it is not the eye that is causing the problem and needs to be healed. The inflammation comes from your bodies immune system attacking your normal eye tissues due to a mix up by being exposed to the herpes virus.

Dr. Rick :

I didn

Dr. Rick :

I didn't know you were going to ask that question when I started typing...I guess great minds think alike lol!

Customer:

So as long as the virus is sitting dormant in my eye will it continue to cause the inflammation?

Customer:

Would boosting my immune system with more sleep, some exercise, antioxidant supplements, cutting down on caffeine and sugar decrease the inflammation?

Dr. Rick :

Yes....and no....Your bodies immune system now sees parts of your eyeball as foreign and it will, unfortunately, attack again and again. As you know, the steroids can "beat back" the attack, but when you are stressed, tired, sick, or for nogoodreasonatall, the inflammation returns. I do not believe that even if you could remove all the virus from the ganglion cells where it hides that it would solve the problem since your own immune system is now on the "warpath" against your eye......does that make sense?

Customer:

Would there be any point in seeing a cornea specialist?

Customer:

yes, that makes sense. In the future if I need cataract surgery will that be more of a problem because of the inflammation?

Dr. Rick :

It might help.....just being healthier, less stressed etc might help....but then again, it might not. I know you have had a long, hard fight with this beast but try to get some positive light on your situation since you can control yours, you are not having terrible steroid induced glaucoma etc.....believe me....it can be much worse. I see it every day in my office (not, of course, to diminish your situation.)

Dr. Rick :

Actually if your primary problem is inflammation the best person to see would be a retina specialist as we tend to treat a lot of difficult ocular inflammation cases....or go to a large University Teaching Hospital where a bunch of Professors could give you the once over...

Dr. Rick :

No. Cataract surgeons know how to treat patients with history of inflammation and cataract. You may have to take oral steroids for a bit and it may take a little longer for the normal post operative inflammation to resolve but you shouldn't have any problems in getting your cataract removed.

Customer:

Also, I heard of a woman with the same symptoms as I have but worse. And I wonder if 5 or 10 years down the road if they will get worse. She says her eye is almost closed most of the time and I have noticed my lid is quite droopy. She also said something about mobililty...not sure if that means decreased ability to move the eye. Also heard that iritis could eventually lead to glaucoma. I do live 1 1/2 hours from Rochester NY and they probably having a retina specialist there.

Dr. Rick :

I trained in NYC and you will have no problems finding excellent docs in Rochester.

Dr. Rick :

That is true about the glaucoma.....both from the inflammation itself and the treatment. Luckily you don't seem to have this issue

Customer:

The virus did do some damage to my vision and I have some scarring that shows up as a white area that I can see. I can see with my eye but it is fuzzy and can't be corrected with glasses. So you see why I'm concerned about the possibilty of further damage.

Dr. Rick :

Just because one person had a particular course doesn't mean you are at a higher risk for the same complications. If you trust your current ophthalmologist and he works well with you I suggest you keep doing what you are doing and deal with any problems when they come up. You could drive yourself nuts with the "what if....and what should etc" way of thinking.

Dr. Rick :

Yes I can understand. It sounds like you have some corneal scarring.

Customer:

Yes I do. Thank you for talking to me. I am just trying to get as much information as possible to see if there's any help.

Dr. Rick :

And I think that is an excellent idea....just be very careful not to get sucked into some treatment that sounds fantastic on the internet. If if sounds too good to be true, it usually is :)

Dr. Rick :

It has been a pleasure chatting with you tonight. I wish you the best of luck now and in the future.

Dr. Rick :

Take care.

Dr. Rick :

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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
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