Keith’s GoutPal Story 2020 Forums Please Help My Gout! Gout Symptoms Who are you going to believe, me or your own eyes?

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  • #3495
    KeithTaylor
    Participant

    Here's one for the “it can't be gout if your toe doesn't hurt” brigade.

    ?

    I was surprised today when I spotted “Subconjunctival urate crystals: a case report.” I almost scanned past it, but a part of my brain registered that it sounded like something to do with eyes. Sure enough:

    Abstract

    PURPOSE: To report a case of localized subconjunctival urate crystals in a patient with gout.
    DESIGN: Single observational case report.
    METHODS: Case report.
    RESULTS: An 80-year-old woman who came for cataract surgery was incidentally found to have subconjunctival crystal deposits near the superior limbus in her left eye (OS). She was taking medications for gout and hypertension. Multiple conjunctival crystals were excised from the area before cataract surgery. Light microscopy under polarization revealed crystals, and histopathological examination confirmed gouty tophi.
    CONCLUSION: Because subconjunctival urate crystals occur only rarely, ophthalmologists should be aware of this potential, particularly in patients with gout.

    And that abstract had a link to a similar case in 2005, that time with a 59 year old woman with a 25 year history of gout. So I searched further, and apparently it is not uncommon.

    Optometry.com lists several links with different parts of the eyes and gout:

    GENERAL
    One of many arthritic disorders that affect the eyes. It is a genetic disease of purine metabolism and renal excretion of uric acid.
    OCULAR SIDE EFFECTS & SYMPTOMS

    • EOM? tenonitis, ocular motor disturbances
    • LID? blepharitis
    • CONJUN? conjunctivitis, pinguecula, red eyes
    • CORNEA? crystalline deposit
    • SCLERA? episcleritis, posterior scleritis
    • IOP? elevated (open-angle glaucoma)
    • IRIS? iridocyclitis
    • VITREOUS? opacities, asteroid hyalosis
    • RETINA? exudative detachment

    I'm wondering if my own inability to wear contact lenses for more than a few hours before becoming cloudy is associated with gout?

    Finally, it wouldn't be GoutPal without a gulp-inducing picture, so the squeamish should look away now (actually, it's quite mild judging by some of the recent contributions) ?

    The patient, a 54-year-old man with longstanding untreated gout, developed progressive redness of both eyes, with an ocular burning sensation and visual disturbance. Ophthalmologic examination revealed hyperemia of the conjunctival and episcleral vessels and multiple chalky deposits on the corneal stroma. Polarized light microscopy examination of a scraping from a deposit revealed typical monosodium urate monohydrate crystals. The patient's serum uric acid level was 600 ?moles/liter (normal 223?487). The patient was treated with allopurinol and colchicine, with significant clinical improvement.

    Gouty Eye

    600 ?moles/liter is approx 10mg/dL

    More gout photographs and images in the Gout Picture Library

    #9469
    hansinnm
    Participant

    Thanks again, Keith.

    “Who are you going to believe, me or your own eyes?”

    I believe you and my own eyes. Lucky for me, I had a thorough eye examination this last Thursday, including two special eye tests(forgot the names) and I am pretty sure that I don't have any gouty eyes. Another reason to get solid 8-9 hours a night sleep.?Laugh

    #11026
    zip2play
    Participant

    OH…MY…GOD!

    ?

    Is there ANYPLACE urate won't deposit?

    ?

    I guess it's logical because the outer surfaces of the eyes must get quite cool in Winter.

    #11007
    trev
    Participant

    Funny how urate, chloresterol and even haemachromisasis can put deposits in the iris.

    [NB: Optic nerve is brain tissue].

    Makes me ask- is urate deposition involved in Alzheimers?- it's gettting so common, just like gout is increasing…

    #8369
    odo
    Participant

    trev said:

    Makes me ask- is urate deposition involved in Alzheimers?- it's gettting so common, just like gout is increasing…


    No, it's protein deposits rather than urate.

    #11003
    trev
    Participant

    I realise that, but I remembered some connection and checked- it's a positive one, like for MS- and SUA? being high in these cases is a 'good thing'!

    Maybe as all the 'bad'?protein gets mopped up in the brain?- as urates grab the action?

    #10997
    odo
    Participant

    Sounds eminently plausible Trev. Seems like the body does its best to lay down deposits of crud wherever it canConfused

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