• Welcome to Crohn's Forum, a support group for people with all forms of IBD. While this community is not a substitute for doctor's advice and we cannot treat or diagnose, we find being able to communicate with others who have IBD is invaluable as we navigate our struggles and celebrate our successes. We invite you to join us.

Possible episcleritis flare

Things have been calm. Except for that thumb/wrist pain that resolved after a couple days, C hasn't had any issues. No GI issues and pt has been going really well. Still doing EN, now 5 nights a week at 4 cartons a night.

He purchased a new video game a couple days ago and has spent most of his free time playing. This is the second new game in a month and both times after the first day his eyes get red. Last time he convinced me it wasn't his episcleritis flaring because it wasnt the normal flare spots(outside corners of the eyes for him). This time it is almost all of both eyes, one worse than the other. I'm going to call this morning to get him in with ophthalmologist.

The GI nurse is supposed to be calling with follow up colonoscopy from February hospital stay. GI wants to do colonoscopy to compare to last year's then if he can't get through IC valve an MRE will be scheduled to get better look and compare to CT done in Feb of this year.

So does episcleritis always run concurrently with active disease? It has for C, first the episcleritis shows up then shortly afterward GI symptoms. But this time both incidents of red eye have coincided with over playing of a new vid game.
 

DustyKat

Super Moderator
Episcleritis runs parallel to disease activity and Uveitis independent of it.

However, it is not at all uncommon for people to complain of red eyes after playing video games, even after as little an hour.

Dusty. xxx
 
I knew episcleritis ran concurrently and it is one of the first signs for C that things are fixing to go downhill fast, usually within a day or two. But nothing so far which I'm wondering if this might be vid game related. I agree on the red eyes and video games but I've never seen it fully engulf the whole white of the eye. It is almost solid red below the iris and to inside and outside corners of one eye. The other is slightly less covered.

Last time the ophthalmologist said that episcleritis is usually self limiting but that when it is an EIM of CD it can run until CD is under control. C's usually only lasts the first several days of a flare. I feel like at the least C may need some type of drops.

C recognizes how bad it looks and that it is occurring, he doesn't think it is episcleritis and isn't keen on yet another appointment. Seems like we have an appt with one doc or another each week, between GI, GP, rheumatologist, dentist and now eye doc. Blech!
 

DustyKat

Super Moderator
:ghug:

If they are bloodshot it wouldn’t be unusual to affect the whole eye.

How long does it last? That may give you a clue as to the problem.

Dusty. xxx
 
Last time it lasted about a week, this time three days so far. We have an appointment with the ophthalmologist in about an hour so hopefully I can get some answers! So hoping for bloodshot from vid games and not episcleritis flare!

Thanks Dusty!
 

DustyKat

Super Moderator
Good luck Clash! :ghug:

I hope it is from the games too…but seems to last a little long for that. It goes without saying that I hope I am SO wrong!

Dusty. xxx
 

Tesscorm

Moderator
Staff member
I was going to ask how long it lasted last time as well. I would think, if it was caused by the video game, you'd see improvement after his eyes rest overnight??

And, completely understand the multiple apptmts frustration. :( As S is away at school, I try to cram everything when he's home over breaks or in the summer but then he complains because it seems like all his plans must be around apptmts. But tell C it does get better... since S's recent follow-up, this year is looking like it will have the fewest apptmts for doctors and tests since his diagnosis (knocking on wood, throwing salt over my shoulder, etc., etc., :ack:).
 
I know I've really felt in freefall mode since dropping the remicade. I know the GI was wanting C to gain weight because he feels the next step is surgery and we were just waiting out that time but I keep thinking if remicade and oral mtx hasn't kept the disease from progressing then mtx injections probably aren't either.

Also these flares of his eyes have coincided with the move from higher amount of EN to lower amount. So that had me wondering if even though C wasn't following a true 90%/10%(more like 90/30 ha) if that was keeping things under control. And so now that we have lowered EN things are going to go downhill.
 

Tesscorm

Moderator
Staff member
Sorry I've forgotten... but why have you reduced EN? Remind me, how many calories and ml is he getting each night? I know you said 4 cartons but how much is that?

Are you still doing 'exclusive' but gradually moving to 'supplemental'?

When S did supplemental, and he would've been about C's age at that time, he did 1500 cals/night, 5 nights per week. There were no restrictions on food or amount (only crohns-related restrictions like seeds, etc.). He'd have his formula and, during the day, would eat a normal lunch, normal dinner and then a meal-like snack. Because of the o/n formula, he wasn't hungry for breakfast but it only seemed to push his three meals forward because his evening snack was often 1/2 a pizza, a steak w/rice, etc. (not a bowl of cereal!).

As EN is supposed to have some healing properties while providing nutrients, perhaps reducing C's EN amount could be playing a role???
 
C was never on exclusive EN nor even a true 90/10. At the time he was placed on EN it was for failure to thrive not for treatment of CD. So he was taking in 2,675 cals or 7 cartons in the beginning nightly plus eating during the day. He was dropped to 1500 calories or 4 cans five nights a week about 2 weeks ago after being at the higher dose for 8 weeks.

Even though he wasnt EEN or even truly 90/10 I do wonder if the drop in formula make cause issues to arise. Especially since starting EN he has had no issues GI wise at all.

We are at ophthalmologist now.
 

Tesscorm

Moderator
Staff member
I can't imagine there'd be any negative to increasing his EN. Not making changes to his diet but just to boost up his amount of EN. Certainly ask his GI but, unless he's at a point where you ddon't want him to gain more weight, what could be the harm in adding another one or two cartons? But I don't know why the GI reduced the amount... there may be a reason the GI wants to reduce the EN??
 
The nutritionist put him on a schedule for the EN for the weight gain so 8 weeks at 2675 calories every night then lowered to supplemental at 1500 for the duration. If I knew he was flaring I would move it back up but without GI issues I think the 1500 is good because he was gaining so fast at the high dose and physical therapy is trying to build muscle for his back and for ease of surgery.

Turns out it isn't episcleritis but some type of conjunctivitis, which is weird to me since there is no itching, pain or visible weeping of matter. The doc said there tad of matter below the lid but all the conjunctivitis I've ever seen was red, painful, and matted together. Anyway, the doc said it could be the contagious or non contagious type so treat it as contagious and now he is on ciprofloxacin drops and off work for several days.

So I guess things on the CD front are still moving smoothly since this isn't episcleritis.

The colonoscopy is set for June 20th, follow up moved to July 8th MRE will be performed in between if colonoscopy doesn't give GI what all he wants to see.
 

Tesscorm

Moderator
Staff member
Glad it's only conjunctivitis (once again, funny the things we think are 'good'!). At least it's not bothering him (ie itchy, pain, etc.)! :)

Well, now that you know it's not a GI issue, no reason to think about adjusting EN dose. :) And, at 1500 cal, it's exactly what S was on. It's worked for S in as far as weight gain and 'steadiness'... somehow, he gained until he was at a good weight and then, even with the extra 1500 cal continuing, he didn't go overweight... his weight just started to stay steady?? Have always wondered how that worked but... whatever... wasn't a bad thing! :D

Hoping you get all good results from the scope!! :ghug:
 
Yeah C has hit 135 but with swimming, work, and clinic pt he has stayed at about 133. I know that doesn't sound like a whole lot but for his build it looks good on him. The pt really wants him to focus on strengthening his core to support his back for the AS and gaining some muscle.

He spent the night off the other weekend and the Mom was babysitting a niece who had a really weepy eye so C thinks that might be the culprit for the conjunctivitis.

Haha you are right on what we classify as good!
 

Tesscorm

Moderator
Staff member
I know it might be tough to convince a teen boy of this but... try asking his PT what they think about yoga as a core strengthener. S swears by it (moreso than PT even) when his shoulder or back hurt. His shoulder has still (again) been bothering him so he's gone to yoga twice in the last couple of weeks. I suggested he go back to physio but he says he gets more relief from yoga. In S's case, the shoulder is an old injury but, I'm sure yoga is quite beneficial in building strength (and I just recently saw a headline somewhere about a study showing benefits to the immune system too).
 
Top