Jayson Sacco:

Welcome to this episode of The Ankylosing Spondylitis Podcast. I can't tell you how excited I am today to have Dr. Grace Levy-Clarke on today. The reason is that she is an ophthalmologist based in the Tampa Florida area. And one of the things that affects not only myself and I have the damage in my right eye to prove it, but many of us is the iritis/uveitis issues that we all deal with. So Dr. Levy-Clarke, how are you today? 

Dr. Levy-Clarke:

I'm doing pretty good and I'm really honored to be here to talk to you and your audience. 

Jayson Sacco:

Well the pleasure is all on my side. Now,we were talking a little bit as we got started, and I should have captured this previous but could you tell me I see a lot of people say oh, I've got uveitis or I've got iritis. They're not exactly the same thing, but they deal with the eye. Is that correct?

Dr. Levy-Clarke:

That is correct. So iritis is actually coming from the root word of Iris. So it's inflammation of the iris. And some of the older textbooks will call it an Iridiagnosis of eye colitis. So it's inflammation of the iris and the ciliary body. And the iris is the area in the middle of which you have your pupil. So when you have inflammation in the front part of your eye, that is called iritis, and it can also be called anterior uveitis.

Jayson Sacco:

Oh, interesting. So, when we go into an Ophthalmologist as a patient, and we have a flare coming up in our eyes, you are going to look at the eye and say, is this affecting front of the eye back of the eye? Does somebody generally, can they get both have the front and the back, inflamed at the same time?

Dr. Levy-Clarke:

Yeah. So you can have in inflammation that starts in the front of the eye and does not go anywhere else. It could start in the front of the eye and progress into the middle and into the back. Or you can even get the reverse. You can get inflammation that starts in the middle of eye and goes into the back or comes forward, but it's primarily when we give it a name. We're looking at where we think the initial focus of inflammation was. But we can look at the eye and at least tell you which parts of the eye are inflamed.

Jayson Sacco:

And I know there are lots of treatments from drops to, when I had my first recorded bout of, of iritis; we didn't know what it was. And it progressed to get worse and worse and worse, to a point where I could get up in the middle of the night and just the light from the streetlight would be like someone was stabbing me in the eye. And it just so happened that it was a Sunday afternoon and I said, I’ve got to go to the emergency room. We went there. And it was just by luck. There was an ophthalmologist there. And he came walking in. And he was he says, “You're lucky since I was just leaving. But he says, Let's take a look.” He goes up, I had, like cloths over my right eye and he said, “If this is what I think it is, you're not gonna like the possible treatment that I have to do if it's as bad as you're saying.” 

So he took the cloth off my eye, and he was Dutch. He was from the Netherlands. So he had a fairly thick accent. And I just remember him looking down and he goes, this is going to hurt you because he says you're going to get hit with all the you know, the overhead hospital fluorescent lights. And he pulled the towel off my I kind of opened my eye up a little bit and of course me I'm just gripping the table in pain. And he goes, all I can remember is the Dr saying “Oh yeah, that's a hot one.” Out came the first time and the only time I've ever had a shot into my eye.

Dr. Levy-Clarke:

So, you you're describing this classic what the...