A person with active systemic lupus erythematosus suffers numerous complications, which as the name itself suggests, involves various systems of the body. Though the cause of the disease is unknown most scientists think that autoimmunity is the primary cause; the body produces antibodies, such as antinuclear antibodies (ANAs), against its own cells. The formed antigen-antibody complexes then suppress the body's normal immunity and damage tissues.
The patient in this case is put in a greater risk not only for infection but in the consistent decline of the body's normal function. Antibodies against tissue components such as RBCs, neutrophils, platelets and almost any organ or tissue are formed in patients with SLE.
This review article focuses on the ocular manifestations of SLE which affect about one-third of those suffering from it. These manifestations range from orbital to irreversible vision loss.
Based on studies, 29% of these ocular manifestations is lupus retinopathy and is greatly correlated to an underlying CNS disease.In my patient's case, she experienced gradual vision loss secondary to vitreous hemorrhage, glaucoma was how the doctor explained it to her.
As a healthcare provider, we have been taught to promote independence to our patients, despite their conditions. Though understandably, a person afflicted with SLE experiences a number of symptoms, one of its greatest blow would probably be losing one's vision. It is one thing to be sick but still be able to perform certain things on your own, but even gradual visual loss-which for her only took a year- would take a longer time to adjust to. She was fortunate to still have the chance of undergoing an operation to restore her vision, though in certain cases, it was no longer an option.
The only thing worse than a disease with an unknown cause is having a treatment not for the condition itself but for the relief of symptoms, as the case in SLE. It is a great realization, especially in my level, that one of the best interventions I can perform does not rely on giving medications to the patient but in staying with the patient on the bedside, talking and listening to her for even if she cannot see me, and though I cannot see her smile behind the mask, her eyes still show that she smiles. And even if she had temporarily lost her ability to see,one never loses her to feel; to be grateful for everything that's going around her and for her.
A reaction on:
Open Ophthalmology Journal (2009). Autoimmune Retinopathy in Systemic Lupus Erythematosus: Histopathologic Features
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