USC student discovers healing partnership at USC Eye Institute

It has been two years since Janae Monfort, who was diagnosed with juvenile rheumatoid arthritis before her second birthday, has experienced any of the joint problems that plagued her for as long as she can remember. But the inflammation in her eye, a condition called uveitis, an eye disease that is a common companion to juvenile rheumatoid arthritis, still gives her problems.

The whites of her eyes sometimes redden, giving the appearance of pink eye, and her vision occasionally fogs, particularly in bright light. It doesn’t cause her trouble in her day-to-day life, but she knows that unchecked, her uveitis could cause permanent damage, even blindness. And so every six or eight weeks, she pays a visit to Narsing Rao, MD, professor of ophthalmology at the Keck School of Medicine of USC and director of uveitis services at the USC Eye Institute, to make sure her treatment regimen is keeping the uveitis in check.

Although fairly common, there is little public awareness about the disease, according to Rao. Uveitis typically presents as redness in the eyes that is usually accompanied by pain, blurred vision, or sensitivity to light. Perhaps because it is not well-known, the condition is sometimes missed by both patients and their doctors.

“If there is redness or some pain, people may not immediately recognize it as a serious condition,” says Rao. “In children, it can be missed by their parents unless the child is really complaining.”

Misdiagnoses or missed diagnoses of uveitis can have devastating consequences. It can lead to cataracts and glaucoma, even in children. The inflammation and swelling is also accompanied by tissue damage that can cause permanent damage to the retina, leading to blindness. In the developing world, unchecked uveitis is still one of the most common causes of blindness. While uveitis can be dangerous, it can be controlled if it is diagnosed and carefully monitored. Rao explains there have been advances in treating uveitis in recent years with the introduction of several new biologic treatments, which has given doctors a wider range of options when looking for the best treatment for their patients. Patients need to see an ophthalmologist with experience treating uveitis to decide which treatment is best.

Rao has been treating patients with uveitis and conducting research on the disease for 40 years. He has conducted clinical trials to assess the efficacy of new treatments and is currently studying the cellular mechanisms that lead to damage to the retina in an effort to find ways to stop it.

Monfort is currently treating her uveitis with eye drops containing corticosteroids. Keeping her eyes healthy also means making an appointment to see Rao every few weeks, who checks the pressure in her eyes and checks the white blood cell count to evaluate the status of her disease and the efficacy of the current course of treatment.

“It is important to stay on top of it because we have to keep tabs on how the patient is responding to treatment,” says Rao.

Because of her arthritis, the Seattle native, who is a senior at USC, says she has spent more time seeing doctors than many people her age. She knows from experience that Rao takes a very different approach to patient care than many doctors.

“I am used to having doctors talk about me or talk at me,” says Monfort. “Until I started seeing Dr. Rao, I never understood this condition. It is nice to feel like it is a collaborative relationship.”

By Hope Hamashige