Fields of Gold

[alfie Wright]

Lovely image, Pete!

I hope everything goes well with the eye, mate! Make sure you give plenty of rest, they're there most amazing tool we have IMO.

I've worn glasses since I was five years old. Getting my first pair was simply the most amazing day of my life & easily my strongest child hood memory, infact I remember very little from before getting them. I'm quite short sighted & my world changed that day! I walked home with my Mum, just pointing in awe of all these things I'd never seen before, or at least never seen properly with all the detail.

Look after them, Pete! Reallt hope every thing goes well for you!

 

[Darren Turner]

Sorry to hear about your health issues Pete, i really do hope all turns out well.

As for the images, stunning work, i love these yellow fields alot.............great work.......... I only ever spot fields like this while flying up motorway where i cant stop or even get close.

Daz

 

[Gavin Robert]

Thanks both. Yes Gavin, head back. Drop into lower part of eye. Bit of a roll open. Bit of a roll closed. Then wipe off any that escapes. Sitting / standing upright would work but this is the easiest way to do it yourself.

Reason I asked Pete was I've been using eye drops for 34 years and found the easiest way is stood in front of the mirror. I pull my lower eyelid down and whilst watching close in the mirror create a drop on the dispenser head near my to eye and. I then touch the inner eyelid with the droplet and traction pulls the droplet across. I then do the usual and roll my eyes whilst slowly releasing my eyelid.
I found doing it this way reduced red-eye so I stuck with it. Also, with a small mirror on the fridge door I don't forget to administer them.

I'm not saying my method is better than anyone's Pete but by sharing our experiences it may help someone.

BTW mine aren't for eyesight issues although I do wear glasses. I don't have VD of the eyes either!

Good luck.

 

[Hamish Gill]

really interesting to see the version of the image as your eye saw it...
As ive said a few times now, i hope it sorts its self out!

The worst eye issues ive had are being hit in the eye with a coin (as i said the other day)
But the most scary thing was when i first had a "floater" ... A big one at that, but i didnt half worry about it!
other than that i have pretty much perfect vision... apart from seeing slightly warmer colours in one over the other ... which is odd, but doesnt effect anything

 

[Brian Moore]

I've worn glasses since I was five years old. Getting my first pair was simply the most amazing day of my life & easily my strongest child hood memory, infact I remember very little from before getting them. I'm quite short sighted & my world changed that day! I walked home with my Mum, just pointing in awe of all these things I'd never seen before, or at least never seen properly with all the detail.

That's a wonderful wee story, Alfie.

 

[Ronald Atchley]

Hi Pete,
I come late to the party again but truly hope your left eye is improving. It's impossible
to say without actually seeing the eye but it sounds like you may have something called
Posner-Schlossman syndrome. The elevated pressure and inflammatory response would
suggest but not confirm this. The only thing odd if it's Posner Schlossman would be the
extremely rapid onset ?? The cloudiness over the central vision probably was from depositon
of inflammatory cells on the inner lining of your cornea ( called KPs ) or a central edema
of the cornea due to very elevated pressure - could be a combination of both. I assume the
drops you're using most frequently are either prednisolone acetate or Durezol and the other
drops are for pressure such as latanoprost, timolol, brimonidine , etc. ?? Regardless, I hope
things are steadily improving. If you don't mind, would you please post more current information ?
Please post me any questions you might have. Sounds like you have "one of the good uns " for
a doc but , still , I've never talked with a doc in my life that I didn't get home and think " you
know I wish I had ask him this "
Ron

 

[Pete Askew]

Hi Ron and thanks. Lesley told us that you were an eye specialist. The consultant I was seeing was pleased that the inflammation at the front of the eye was virtually gone but was concerned about a small area of inflammation at the edge of the retina. His suspicion was that it was either a systemic Candida infection or, more probably, a protozoal infection. The specialist I saw today confirmed the latter (99% certain). Obviously they could sample the vitreous and aqueous humour and use PCR amplification to look for evidence of the protozoan but he would prefer to avoid such an intrusive procedure. Similarly the anti-protozoal medication is not without significant potential side-effects and there is only weak clinical evidence that they do any good. So I will continue with the drops (but reduce the steroid to 3 times a day) and they will check the patch of inflammation regularly. He anticipates that the immune system will suppress it on its own and although the protozoan will probably encyst, there is as good chance that it will not reoccur. There is a small amount of pigmentation associated with the 'lesion' but so little that he suspects it is a new infection rather than a re-activation.

Just so you can check your score (pretty good by the look of it ), the medication I have is:

Cyclopentolate HCl (1%) twice per day but I can reduce that now to maybe every other night.
Timolol (0.25%) twice per day.
Latanoprost (50mg/ml) once per day at night.
Prednisolone acetate suspension, now 3 times per day (was hourly for the first few days).

Most of the issues with sight now are the result of the partial dilation of the left pupil but I can live with that and just reduce the amount of time I spend looking at a screen.

The rapid onset was probably a response to the inflammation and the sudden 'detachment' of the vitreous humour from the retina.

Interesting (although I'd rather it was interesting on someone else) and I always find it slightly amusing (ironic is probably a better word) when I get anything like this as I am a microbiologist by profession specialising in microbial control. I have this feeling that those microorganisms know this and are just waiting for their chance to get revenge (malicious quorum sensing I reckon)!!

 

[Ronald Atchley]

Considering what you're describing, it sounds as though you were very
fortunate to see the specialist you did and when you did. Wether fungal
or protozoan, these can be absolutely devastating as you know. By "edge"
of the retina, I assume you mean anterior? ( Much better there than in the
posterior pole or macula. )
Really glad to hear you are improving ! You really "dodged a bullet"
Ron

 

[Pete Askew]

Yes, anterior and almost beyond the periphery of vision. He's pretty certain it is protozoan (Toxoplasma) and they will continue to monitor it.

 

[Ronald Atchley]

Pete,
Did a little digging and came up with some numbers on toxoplasmosis
in adults. The published rate in the article I found was 18 per 100,000.
Was wondering if they've suggested any other testing be done ?
Oh, other studies have suggested a relationship between toxo and attention
deficit disorder, obsessive complusive disorder, and schizophrenia. Now ,
at least , you have an excuse
Ron

 

[Pete Askew]

Me? Obsessive, compulsive? Never. But he is and... Oh look, that's interesting...




Yes, an interesting little organism (or big, from a microbiological perspective!). He doesn't plan any further tests unless there is a change to the lesion etc. He fully expects it to encyst and hopefully it will not reactivate, at least not in the near future - at least I know what to look out for. Sampling the aqueous and vitreous humour is obviously not without its risks and would probably do no more than confirm his clinical diagnosis (he is one of the 2 main experts in this area in the UK). I read a couple of papers where they have correlated antibodies in the blood with confirmed infection in the eyes but this does not seem to be used in diagnosis. Another series of references suggest that a significant proportion of adults have, at one time or another, contracted an infection with Toxoplasma probably with either no or only mild symptoms and none in the eye. I guess they may confuse the results obtained from blood which is why sampling the fluid and visual diagnosis are still the preferred route. The anti-protozoal drugs only work on the vegetative state and do little to control the organism and seem only to be recommended in immunocompromised individuals and if there is a risk of infection to the rest of the CNS.

Cats appear to be a major vector of the disease along with dietary factors. I found it interesting that you are fours times as likely to contract the disease in much of mainland Europe than the UK and that this was almost certainly due to dietary factors: such as eating more cured meats like salami, eating raw pork etc. I eat virtually no meat except the occasional piece of free-range lamb / mutton and pork. I certainly don't eat even rare steaks which probably means my infection was more likely to have been either environmental (contaminated soil / water) or another food (unwashed salad and the like) or maybe through direct hand to mouth by petting an infected animal and then handling / eating food (even though, as a result of being a microbiologist, I am extremely good about washing my hands).

So those of you with cats and young children (Hamish et al), make sure the cat is vaccinated against Toxoplasma and keep the kids away from the litter tray!!

 

[Ronald Atchley]

Just checking in. Wondering how your eye is progressing.
Hope all is well.
Ron

 

[Pete Askew]

Thanks Ron. Still on the drops and the next detailed examination is on the 30th. Focus has been bugging me for the last few days (probably just a combination of the dilation drops and some debris / deposits of protein) and I'm going to get the pressure checked in the morning (I'm now back in Potsdam and the specialist is in the UK). Hopefully the inflammation will be much reduced soon and the medication can be reduced - I'm told it could take another 2 moths!. Thanks again for asking.

 

[Paul Lange]

Good to hear things are better Pete. I read something about Toxoplasma or at least I think it was that. Apparently it is evolutionary as it helps cats hunt mice and rats. When these animals get infected they take more risks including populating areas despite being able to smell the scent of a cat and it's urine. The non-infected stay well clear of these areas. For most people infection by Toxoplasma has no obvious effect however studies have show that, like mice and rats etc., they are slightly more inclined to take risks more so.

I have no idea why someone might find that nugget interesting but you never know.

 

[Pete Askew]

So, do you think I should cancel the sky diving and bungy jumping course in Nigeria I've just signed up for?!!

 

[Pete Askew]

I had also read about the apparent reduction in fear of rodents when infected. Interesting and I guess another superb example of co-evolution. Like in many mammals, Toxoplasma gondii cannot complete its life-cycle in man but can reside as cysts for decades, occasionally re-emerging to cause localised lesions, often in the eye. I've always found protozoans interesting but to be honest I'd rather they were in a book than my eye!! Hopefully they will encyst soon and I can get back to normal.