Conjunctivitis and PA

** Originally posted by TaraFIU **

I posted about this in my “PA or Chronic Lyme” thread, so sorry if this is a repeat read for you. I got some good advice from one member, but I thought I might get more responses if I started another thread.

I have had chronic pain from Lyme for the past 15 years, but recently (past year or so) I have experienced an increase in pain (but it is variable… come and go) and I suspect possible PA.

I have had a pretty bad cold since last Tuesday. This Tuesday, I went to the Dr. and got some antibiotics for this cold. I did not stop my enbrel, so that probably contributed to why the cold was so hard to shake. I’m finally feeling better, but am still not 100%

While I was at the Dr., I brought up PA and asked for blood work. She ordered my cbc and sed rate and rh factor (and some other stuff). I only got a few seconds to chat with her (I didn't expect too much since I showed up without an appointment), but she seemed completely unconcerned about PA saying that since I exercise, that is the most important thing. Kinda comforting and kinda frustrating.

So anyway, I guess I am on my way to some answers about if I have PA. I have been avoiding doing the testing b/c in a silly way, I don't want to know/have to face it. But already being in the doctor’s office, I couldn't help but be efficient (I have such a hectic travel schedule).

One other thing though, since last Friday I have felt a little pain discomfort in one eye. I thought I might be getting a sty or an infection, but nothing really materialized. It still feels a little irritated. I mentioned the eye irritation to the nurse, but forgot to bring it up to the doctor (in our rushed interlude). I can't believe I forgot to mention this to the Primary Care!!!! Errrrr!

I didn't think too much about the eye, until I was just reading that conjunctivitis can be involved/indicator in PA. I had really bad conjunctivitis about a year ago, I'm thinking around the time of the onset of the new pains. I guess there is no need to speculate until my blood work comes back, but hmmmm.....

What really has me suspicious is that the pink eye I had last year was really bad. I mean really bad. The eye dr. said he hadn't seen such a bad case in 10 years. He even called in his colleague to check it out.

I called the Ophthalmologist and I have an appointment for Monday afternoon.

The eye irritation I have has been stable over the past week. My eye is still in the same condition. I'm not sure that this is conjunctivitis b/c it is so mild. I thought pink eye spread quickly. I guess I could have a mild case.

I am thinking that the last time I got the pink eye was right after a cold as well. Perhaps my sinus congestion is affecting my eyes or something?

I remember reading a post from someone on this sight (I think Daniel) that people with PA should have a thorough eye exam annually. Any special tests that I should ask the eye doctor about?

Report post

22 replies. Join the discussion

** Originally posted by ChrisK **

TaraFIU

One, the blood tests you did will rule out other types of arthritis. There is no lab test specifically for PsA which makes it difficult if your doctor is not well educated about PsA, he/she may not know what all to look for. So you really need to find a rehum that knows PsA. You didn't give enough information as to why you think you may have PsA. This kind of information is important when you are talking to your doctor (i.e., family history of P or PsA, you have P...). We can't diagnose you, but we can give you information and support.

Second, when you see the eye doctor have them check for "Iritis".

http://www.webmd.com/eye-health/iritis

Well I wish you well. Take Care! -ChrisK

Report post

** Originally posted by TaraFIU **

I think I have PA b/c I have joint pain and psoriasis. I have had scalp p since I was an infant and guttate p since I was 21. I am on enbrel for p. About 70% clear. There is a family history of p, but not PA (that I know of).

Since there are no good tests for PA, I was thinking that the eye involvement might be helpful diagnostically as an indicator (in combination with the blood test results). Like, having conjunctivitus would make unclear bloodwork be more suggestive of PA.

I will check on the Iritis. It doesn't sound like what I am experiencing (thank godness), but that eye condition also has p and Lyme as possible causes.

I was hoping that the eye invovlement might help distinguish between a Lyme cause and a P/PA cause for the increase in joint pain I have been experiencing.

I don't have nail p involvement or saussage fingers/toes.

I do have dull aches in joints (shoulder, knee, anke) that come and go. The pain seems to be asymetrical. Triggers seem to be: rainy weather, cold weather, sleeping in fetal position, running (especially on incline), sitting long periods of time and being tired/ill.

Occasionally, the dull aches are combined with more sharp/accute aches.

Does that sound like PA?

Report post

** Originally posted by MikeK **

Eye problems can be a sign of PA. (I'm aware of at least one person whose PA was diagnosed because of chronic eye problems.)

I have mild intermittent PA. (I now see my rheumy twice a year.) My rheumy requires all of his PA patients to undergo eye exams at a teaching hospital. (I to go State University of New York's Optometric Center.) This link will eventually take you to several posts about PA and eye problems; please follow all of the links: http://www.psoriasis.org/forum/showthread.php?p=381533&highlight=suny#post3 81533.

As I mentioned in my other posts, the link to the article that Cat (SeeDoubleYou) gave us in one of her posts (here's a link to it: http://www.psoriasis.org/forum/showthread.php?p=298253&highlight=excellent+ article#post298253) should be required reading of everyone who has PA. (It should also be required reading of everyone who has psoriasis and/or who thinks that they have PA.)

I hope this helps.

Mike

Report post

** Originally posted by ChrisK **

Mike do you have any links to pictures of these eyes conditions. I've talked to my doctor in regards to these blisters I get on the ridge of my eyes lids, kind of like a stye, but I have like 30 of them between the 2 eyes, top and bottom. All he said is that it's part of the disease progression of P and PsA. He didn't give me a name for it.

TaraFIU, Mike gave a good link. The fact that you have P and inflammation w/pain would make a good case in itself. Did they do some kind of test on you for the Lyme disease diagnosis (it has similar symptoms to PsA). I've had PsA for 24+ years and P 30+, I have spinal, hips, knees, hands, elbows, shoulders, neck, feet and ankle involvement. My pain can yo-yo, weather being a major factor, stress, and over doing it. I definitely feel for you, and wow if you have both. It sounds like they have you on the biologicals. I can't do those, so I just treat the pain (if you go to my thread "My PsA Made Me Cry" I talk about it).

Take Care! -ChrisK

Report post

** Originally posted by MikeK **

Hi Chris,

I don't have any pictures at the moment. (I'll look for some -- I'll let you know either way.) I know that you're not working, but I wonder if it might be worth your while to come up from Philly? SUNY's Optometric Center is a only a couple of blocks from Times Square: http://www.sunyopt.edu/. It's within walking distance from Penn Station (you can take the subway). It takes forever to take SEPTA from 30th Street to Trenton; but the ride from Trenton to New York via New Jersey Transit isn't that bad. I do it all the time for work.

I'm not sure if there's an equivalent to SUNY's Optometric Center in Philly? Maybe HUP?

Mike

Report post

** Originally posted by ChrisK **

Thanks Mike, I currently don't have insurance, and my doctors are all HUP physicians. I just can't afford to see anyone other than my PCP.

-ChrisK

Report post

** Originally posted by szorzi **

Tara, for some doctors just knowing you have joint pain/inflammation plus P is enough for them to diagnose PA.

How long have you been on Enbrel? It's also used to treat PA so it could have been masking joint pain you might have noticed sooner had you not been on Enbrel. You might need to move to another biological, especially if you've been on Enbrel for several years.

Report post

** Originally posted by TaraFIU **

TaraFIU, Mike gave a good link.

Did they do some kind of test on you for the Lyme disease diagnosis (it has similar symptoms to PsA).

Yeah, thanks Mike. You always come through.

After two years of inconclusive tests, I did test positive for Lyme on a Western Blot. I was treated with IV and oral anitbiotics. The antibiotic treatment relieved me of all symptoms (joint pain and neurological) except the joint pain in my hip. I have since suffered the chronic hip pain. It is common for people who have a delay between infection and receiving treatment with Lyme to suffer some long term symptoms of Lyme. This phenomena is known as Chronic Lyme Disease. My bout with Lyme was 15 years ago. I no longer test positive for Lyme.

I doubt that the new pains are from Lyme, but you never know. The Lyme bacteria can hide in your tissues and spinal column.

I doubt that I still have an active Lyme infection, but I can't help but wonder about the effects that enbrel could have on latent lyme.

The new pains started about a year ago, but got worse after I went on enbrel. At first the pains were only during exercise. Now they come and go at all times. The length of time that the pain lasts is highly variable.

Report post

** Originally posted by TaraFIU **

How long have you been on Enbrel? It's also used to treat PA so it could have been masking joint pain you might have noticed sooner had you not been on Enbrel.
.

I have been on enbrel for about 6 moths. The new joint pains started about a year ago, but intensified shortly after starting enbrel.

Report post

** Originally posted by solarflare **

Hi I have just recently started to really suffer from eye problems. I had dry eye start when I was awake on and off at night with all three chidren, when they were babies. The eye specialist said there was a tiny cist under the lower eyelid but it would probably eventually disperse.
Last august I started to get really dusty eyes red raw and painful deep dull pain in my eyes. This was eventually daiagnosed in december as Blephiritis by the optician. When I told my doctor she said I was wondering when that would crop up its another classic symptom of PsA!
I thought oh so its not going to go away then. She gave me some tears eye drops and said just keep doing what the optician said. which is to lay a hot flannel on the eye and then gently rub in some baby shampoo mixed with boiled water in and around the eyelashes.
Apparently all the tear ducts are blocked hence the dry eye and pain.
As far as being diagnosed yes there is no specific blood tests only ones to rule out the other types of arthritis. My rheumy said it can be identified by the feet and hand xrays.
And the other signs are the feet(heel), and neck pain,this is what I got from a leaflet from the hospital.
Hope this helps

Report post

** Originally posted by TaraFIU **

As far as being diagnosed yes there is no specific blood tests only ones to rule out the other types of arthritis. My rheumy said it can be identified by the feet and hand xrays.

Hi Solarflare. Sorry to hear about your troubles with Blephiritis.

Would the hand/feet Xrays be helpful in a case with no hand or foot joint pain? Could an Xray of an involved joint (for me the knee or shoulder) be helpful diagnostically? Do you have to be "flaring" at the time of the Xray?

Report post

** Originally posted by TJM718 **

Back in 2001 I got pink eye so bad I was out of work for six weeks and was one day away from being hospitalized. I had a two week period where I had to go to the eye doctor evey single day to make sure it wasn't getting worse. I had to use medicine that made it hard to see. It stunk. It cleared up and that was the last of it. I had never had it before. Mike K told me about the PA connection. I think there's validity to it. In my case it just seemed to be a one time deal. I was out from work less when I had shoulder surgery. Good luck and keep us posted. TOM:)

Report post

** Originally posted by TaraFIU **

Back in 2001 I got pink eye so bad I was out of work for six weeks and was one day away from being hospitalized. I had a two week period where I had to go to the eye doctor evey single day to make sure it wasn't getting worse. I had to use medicine that made it hard to see. It stunk.

I was out from work less when I had shoulder surgery. Good luck and keep us posted. TOM:)

OMG. And I thought my last bout with pink eye was bad.

What I have going on right now is mild. I'm not sure that it's pink eye b/c it hasn't gotten any worse. I guess I'll know soon. I have the Opthomolgist appt tomorrow afternoon. I prepared a list of all of my symptoms and the onset dates as well as all of the PA related eye conditions.

Report post

** Originally posted by TaraFIU **

So, I went to the opthomologist this afternoon.

It turns out that what I have going on with my eyes is blocked glands. The little glands in the eye lid became somewhat blocked. Apparently this is common in the dry skin conditions (psoriasis, eczema).

The dr. used a little wood sick and unblocked the glands. I already feel some relief. He also gave me some ointment to apply to my eyes at night. He asked that I return to have the unblocking done again in a month.

Report post

** Originally posted by solarflare **

This is exactly what my optician told me I had and that little remedy which really helps is:
run hot water on a flannel and rest it on your eyes for a few minutes. Then mix a little baby shampoo with some boiled water and rub that mixture into your eyelids around the eyelashes(obviously keeping the eyes shut. And rinse. It doesnt get into your eyes. I was told to do this for every day for a month as it is stubborn. Then do once a week to keep the ducts clear.
My doctor and my optician were in agreement with this as well as artificial tears.
I hope you are able to get some easement soon.

Report post

** Originally posted by TaraFIU **

Thanks solarflare!!!

I'll try the baby shampoo cleaning compress ritual before I apply the ointment at bedtime. Does it have to be flannel fabric or is a washcloth okay? I don't know if I have any flannel in the house (don't wear flannel too often in south fl, hee hee).

I already feel some relief from the gland cleaning :). It did hurt a little though. The dr. wants me to come back for another gland cleaning in a month. He said it may hurt more next time.

I will definately try your strategy to keep the glands clear! Thanks again.

Report post

** Originally posted by TJM718 **

I'm so glad you got some answers. I had something in my eye once called a chalasion which I am sure I spelled wrong. It's basically a giant pimple inside the eyelid that grows to the size of a marble. It wasn't pretty and I had to wear an eye patch. My doctor told me the same thing about washing my eyelids with baby shampoo. He also had me doing hot water compresses several times a day. Not boiling obviously but extra warm. This was to help break up the oil. I wouldn't do that unless the doctor told you too. Anyway, I hope you get some relief soon.

Tom

Report post

** Originally posted by frogwhiz **

You know...this is interesting. My son is 16 and has had P since he was 6 months old. When he was a baby his eye glands would get blocked and we would have to massage it. His eyes would get matted pretty bad when he was sleeping if we didn't. After a couple of months it seemed to correct itself. Wonder if it is the same thing.

Report post

** Originally posted by TaraFIU **

I forgot to use the eye ointment thus far (haven't used it yet), but my eye condtion continues to improve. I still have the sensation of irritation/dryness and an increased need to sweep the inside corner of my eye with my finger, yet my eye is feeling better by the day:). It seems that the effects of the gland "declogging" have improved over the past two days.

I'll keep you guys posted. I'm scheduled for another "declogging" that will be more intense/painful in a month. Oy!

Report post

** Originally posted by stv8r **

Hi,
I find your post fascinating, because I have been experiencing similar problems with my eyes. I was diagnosed last year with P, and my derm has been keeping an eye on a few fingers and toes for suspected Pa. I recently went to the eye Dr after I scratched my eye with my contact lens(from being so dry). He told me it was because I was getting older(42...lol). He gave me some antibiotics, and recommended the baby shampoo method of cleaning my eyes as you mentioned. He also switched me to a new brand contact lens with a higher moisture content. Long story short, I am still having a lot of dry eye problems, and wear glasses 1/2 the time now. Thanks to your post , I will bring it up at the next Derm appt! I would have never connected the 2. Might not be a connection, but it is worth mentioning.

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support the National Psoriasis Foundation

Help the National Psoriasis Foundation reach its goals and support people like yourself by making a donation today.

Donate to the National Psoriasis Foundation

Discussion topics

Additional resources

Community leaders