Moorfields Eye Hospital, University College Hospital, University of Birmingham, United Kingdom, Wegener's Granulomatosis (WF), is an interstitial non-cancerous mononuclear inflammatory disorder of unknown cause. This disorder occurs due to the invasion of white blood cells into the eye pouches in the macula. The disease starts causing inflammation and damage to the optic nerve. It is estimated that up to 70% of all cases of WG occur as a result of intraocular pressure, which is caused by increased intraocular pressure generated by ocular hypertension and eye movements.

 

Eye surgeons find the disease by means of biopsy. Biopsies are normally taken from the iris and choroid, or when the disease has already spread to the brain. Biopsies are taken from different areas of the body to study the occurrence of the disease. Eye surgeons will do the biopsy on both normal and affected eyes and examine the ophthalmic vessels, blood vessels, and other tissues. A high degree of sensitivity is required to diagnose WG and also to measure intraocular pressure.

 

After an ophthalmologic examination, the ophthalmologist will determine if a specific part of the eye is affected. In this case, the eye surgeon will take fluid samples from any orifice and from the eye.

 

A trained ophthalmic surgeon will be able to perform the procedure using laser coagulation to remove gritty debris that has accumulated inside the eye. In most cases, laser coagulation of the eye is successful, but in some cases it may be necessary to use an excimer laser.

 

Eye surgery is very expensive and difficult, and the recovery period can be very long

 

In some cases, treatment may be unsuccessful and granulomas may recur. In such cases, the patient needs to re-operate on the eyes. In other cases, surgery is not required, and the patient is given the opportunity to recover on his own.

 

Typically, the diagnosis of WG is based on a complete blood count, a specific antibody test, and a specific enzyme-linked immunosorbent assay. If the test is positive, the optometrist will perform an eye biopsy and computed tomography. to determine the type of granular waste and the degree of contamination. If an eye surgeon suspects it is WG disease, he will perform a simple surgical procedure called arthrocentesis and then look for a blood product called urates that have been present in the eye for a long time.

 

In most cases, surgery is practically not necessary, but there are times when a small amount of granular material needs to be surgically removed, especially if the cause of the disease is genetic problem. In this case, the eye surgeon takes a small amount of fluid from the eye and places it in a container containing silver nitrate, and then freezes it to -70 degrees Celsius to kill bacteria.

 

This solution is used to destroy all antibodies and other immune complexes that have been found. Then the substance is injected into the eye. If no response occurs, a sample can be collected and cultured to make more culture. This culture can be used to determine whether the immune complexes are mononucleated or whether the infection is the result of a chronic infection.

 

If the eye surgeon detects that the infection is indeed due to WG, he will probably recommend surgery. If there are no complications, the surgeon can suggest that antibiotics be given to patients.

 

Although eye infections can be life threatening, they are quite rare. But if the infection is caused by a genetic condition or inherited immune complex, the prognosis might be poor.

 

Wegener's granuloma and other eye infections are usually easily treated with antibiotics. The eye doctor will use eye drops to clear the affected eye and will prescribe an ointment or cream for the surrounding area. In some cases, antibiotics may be necessary to remove all the infected tissue.