The Link Between Crohn’s and Scleritis
I remember the year was 2014 and just before spring. It was when the last available, at the time, biologic failed me. I noticed my treatment wasn’t controlling my Crohn’s, psoriasis, or psoriatic arthritis symptoms very well.
My quality of life wasn’t so great, but the good days would make me question everything. Then something happened, during a 3-hour drive home, my eye began tearing. There was also a dull stabbing-like pain that was coming and going. This was not good.
Eye discomfort and tears while driving
This happened to me a decade before and ironically it was during a long drive. During college, around 2003, I had to do a four-plus-hour drive from NJ to pick my mom up at a NY airport. Imagine driving four hours with a hand over one eye to shield it from the sun because you forgot to take your sunglasses.
It was a constant stream of tears and discomfort. Thankfully, she did the rest of the driving on that trip including an emergency trip to an optometrist. I was misdiagnosed back then with severe IBS, sadly I know now that this is a complication associated with active Crohn’s inflammation.
It was about 45 minutes into my drive home when my eye began to tear worse than a reality star caught in a bad lie. It was a constant stream of tearing coming from the eye. Every so often, I was struck with a dull but stabbing pain.
It’s not normal, yet I had normalized it.
Dismissed by the eye doctor's office
After finding a safe place to pull over, I looked for a pair of sunglasses and called my eye doctors. The receptionist was adamant about a two-to-three week wait. She then said, “You were here not that long ago.”
I put my sassy pants on and replied, “Correct. And when I was there, Dr. D told me to come in immediately if there was an issue. This is an issue.”
She asked me to repeat the symptoms, “Eye is watering continuously, dull stabbing pain. It’s uncomfortable.”
I felt like she was dragging the call along. With the office closing at five o’clock, I saw my window of getting there before five closing-in rapidly. So, I put her on speaker, grabbed a napkin for my eye, and got back on the road.
I got to the office fifteen minutes before closing, and they ushered me to the exam room.
This is where listening to your gut pays off.
I see both an ophthalmologist and an optometrist at the office due to higher-than-normal ocular pressure in both eyes due to inflammation. Crohn’s disease is the perceived culprit of the inflammation.
The optometrist diagnosed me with scleritis, made a prescription, printed some notes for my Rheumatologist and GI, and scheduled me for a follow-up.
Serology and antibody tests for the biologic
My Rheumatologist had me come in when the next dose of the biologic was due and drew labs. One of the labs was a serology and antibody test. She felt this was one more sign that I was either developing a resistance to the treatment or developed antibodies.
A few weeks later the results came in. That awful feeling knowing that once what kept me afloat wasn’t going to be for much longer was sinking in. Sure enough, the results were poor. They showed the highest antibody scores both my Rheumatologist and GI had ever seen. My serology score was zero, which meant that there was zero medication in my system as of injection day.
That last injection was my very last injection.
Scleritis was a sign of medication losing effectiveness
A few days later, I met with my then-IBD specialist. She confirmed what I had feared. Scleritis was one more sign that the medication was not working.
Scleritis and episcleritis are common extraintestinal manifestations experienced by persons with Crohn’s disease and ulcerative colitis. Uveitis is another ocular extraintestinal manifestation that people with IBD deal with.
So, when your body tells you something is not right, listen to it and call your doctor.
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