04 November 2013

Cloudy With a Chance of Toxo



In 2010, after a trip to Argentina*, I started to see black spots in the vision of my right eye. These were accompanied by an annoying blurry spot. Every time I looked anywhere these blurs and spots would move (often making me swipe at what I thought was a fly. Yes, I did look crazy swiping at nothing!).

I put up with it, after all, I could still see well - never worn glasses. But at a certain point I thought I had better bite the bullet and go see an Optometrist. Clearly I was going to need glasses...

... However, I had a huge shock: your retina is detaching. The Optometrist was on the phone to both private and public clinics as I needed to go to a specialist urgently.

Stunned, a arrived at Greenlane Clinical Hospital after 2pm sometime, referral letter in hand, and the wait began. At 5pm only a select group were allowed to stay; the rest sent home.

Around 6pm my darling Mum arrived - she'd decided not to fly to Christchurch with Dad that night. Instead she dropped him at the airport, and came to me.

Around 9pm I saw the specialist. He confirmed my retina was detaching, and if he could see a tear (or whatever it was he was looking for) he would've put me under the laser on the spot...

The next week I had an appointment back at the clinic. To me this was to be a follow-up; a closer look at me eye. Instead I saw an extremely rude woman doctor who implied I must've demanded an appointment ("Oh, YOU got an appointment fast..."), and spent approximately 5 minutes with me. This was a whole day off work, with my Mum. I thought I was going to go blind in my right eye and I have a doctor judging me (white girl using up the system??!! I pay for public heath too).

After a third appointment later on, with the rude doctor's boss no less, he declared that my retina wasn't detaching. Rude doctor was in the room at the time. I think she had the decency to look a little sheepish when he declared: "Who on earth thought this? These are white blood cells".

Blood tests, appointments with eye specialists in auto-immunity... My test came back positive for Toxoplasmosis. Only a biopsy would show if this was actually the cause, but the assumption of Toxoplasmosis was my diagnosis.

So what is Toxoplasmosis you ask? The 'cat disease' (I loooove cats BTW).

Toxoplasmosis is caused by Toxoplasma gondii, an intracellular protozoan parasite. Its main host is the cat, although contact with raw meat, especially pork, is a more significant source of human infections in some countries. Up to a third of the world's human population estimated to carry Toxoplasma. It is one of the most common human parasites.

Toxoplasma infections may present in four main ways: 1) Acquired infection in immunocompetent adults and children (This is asymptomatic in most case), 2) Ocular toxoplasmosis (Possible symptoms are reduced visual acuity, and floaters), 3) Congenital infection in immunocompetent patients (The mother is usually asymptomatic. The fetal consequences are more severe if infection takes place within the first ten weeks of conception. The risk of maternal-fetal transmission increases as the pregnancy proceeds but the consequences become less severe), and 4) Immunocompromised patients (Toxoplasmosis can be life-threatening for immunocompromised patients, usually due to reactivation of chronic infection e.g. those with AIDS).
My concern (at the moment) is with the treatment of ocular toxoplasmosis: decisions about treatment should be made by an ophthalmologist familiar with the disease. Treatment aims to reduce the risk of permanent visual impairment (by reducing the size of the retinochoroidal scar), the risk of recurrence and the severity and duration of acute symptoms. However, there is a lack of evidence about the efficacy of antibiotics, and traditional short-term treatment of active toxoplasmic retinochoroiditis lesions does not prevent subsequent recurrences.
And, funnily (?!) enough I found this: Crazy Cat Lady Syndrome, also known as Crazy Cat Person Syndrome, is a term coined by popular news organizations to describe scientific findings that link the parasite Toxoplasma gondii to several mental disorders and behavioral problems. The term Crazy Cat Lady Syndrome draws on both deep seated cultural stereotype and popular cultural reference. Cat lady is a cultural stereotype of a spinster who compulsively hoards cats and dotes upon them. Crazy Cat Lady is also a popular cultural reference to the Simpsons' character Eleanor Abernathy who acts like a stereotypical mentally ill person.

So, Toxo is a parasite in the blood that might go undetected. Or it can cause symptoms, like Toxo Retinitis - what I have. Unfortunately, once you have this, it WILL reoccur.

I've been treated for it once before, and had a few little 'flare-ups' along the way (some inflammation in the eye, therefore more white blood cells floating around, and possibly a detachment of some jelly, which then floats in the eye causing blurriness). It's left me with two scars in my eye; blind-spots. I am lucky that these don't effect my vision (vs. being in the middle of my field of vision).

Three years later, the Toxo is back with vengence. Tons of black dots in my vision, like a swarm of flies. And a large blurry shape. Friday I head to my trusty Optometrist (for $40 he does an eye health check and tells me if I actually need to go to the hospital. Saves me time and worry!). He confirmed that the Toxo was back, and wrote me a referral letter for the hospital (helps speed up the process).

8am Saturday morning I'm the first one at the acute eye clinic (though not for long). I see the nurse, then a really wonderful doctor, then my eye is scanned (using something like an echo that bounces off everything so they see a complete picture of the eye, including all the floaters etc.). And then another doctor.

(Photo of my eye scan)



I'm now back on treatment. There is a new inflammation next to the two old scars (this will end up being a scar too). Again, I am lucky that the infection is not in a 'vision threatening' position (not near a major blood vessel or the Macular).

Treatment consists of: steroids, a specialised antibiotic, and a 'stomach protector' (so the other drugs don't hurt my stomach lining). This morning: 12 steroid tablets, 2 antibiotics (I have to take 2 tablets 3 times a day), 1 stomach protector (plus my normal drugs). I also have 'Pred Forte', a steroid eye drop (apply 1 drop every hour...).

This will all help my body fight. Unfortunately, the side-effects of steroids on me are not fun (weight gain, puffiness, insomnia...).

I still count myself lucky - there are people suffering around me, people I know and work with.

I hope the treatment works!

xo


*I actually have nooo idea when I 'got' toxoplasmosis. I could have had it for years.

Links: http://en.wikipedia.org/wiki/Toxoplasmosis, http://www.patient.co.uk/doctor/toxoplasmosis, http://www.patient.co.uk/doctor/Chorioretinal-Inflammation.htm

2 comments:

  1. I have this too in the left eye but it effects my whole body. It's I have a really bad flu and my head feels like it's going to explode.

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    1. I am so sorry to hear that :( I've never experienced the flu-like symptoms they talk about, but it's come back to my eye 3 times now. Has yours reoccurred?? I hope your sight is still okay?

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