In eye care, there are those who are fortunate enough to only have a minor condition that’s easily remedied through a routine procedure. However, there are others who are sadly burdened with chronic diseases. In these situations, quality of life is dependent on both the treatments and procedures performed, and the long-term care provided by their care team.
Alison Le Cann* is one such case. When Alison was only 13 years old, she was a diagnosed with uveitis, a disease which causes vision impairment and eye irritation. At the time, she was prescribed eye drops which quickly remedied the issue.
What she had yet to learn was that uveitis is a type of inflammatory disease, which destroys eye tissues over time and can cause severe vision loss through persistent flare-ups. There is no known cause or cure, and while the disease can be temporary, Alison’s uveitis eventually became chronic.
By the time Alison hit 19 years old, it was evident that this condition would not be disappearing any time soon. Her flare-ups were happening closer together and she now had to contend with the additional diagnosis of inflammatory arthritis, a related condition. Needless to say, her doctors were concerned. She was sent to see an ophthalmologist in Toronto who told her the worst — that this disease may take her eyesight.
Refusing to let this news stop her from living life to the fullest, Alison moved to British Columbia where she would come to meet her current care team. This team was headed by ophthalmologists Dr. N. Kevin Wade and then Dr. Briar Sexton, who are eye doctors able to perform surgeries, treatments, medication prescriptions and formally diagnose patients. In conjunction with her family physician and rheumatologist, Dr. John Kelsall, Dr. Wade first prescribed immunosuppressive drugs for Alison to stem her worsening condition. Dr. Sexton followed up with her care.
At 23, Alison developed glaucoma in her right eye as a result of the degraded tissue, inflammation and powerful drugs. Glaucoma is dangerous as it can cause a rapid loss of vision due to rising pressure in the eye. The effects of glaucoma can include pain and nausea, both of which Alison experienced. Luckily, ophthalmologist Dr. Robert M. Schertzer successfully performed two surgeries and relieved the pressure.
Over the next decade, Alison would be prescribed a variety of powerful drugs as her care team worked to find which one would be most effective against her disease. One drug, similar to a chemotherapy agent, would cause weight-loss and nausea for several years. It was at this point that her ophthalmologist, Dr. Sexton, suggested using a new type of drug that was similar to a biologic drug for cancer, MS and Crohn’s disease. This powerful drug was administered via intravenous (IV) infusion in the hospital every six weeks. The IV treatments helped put her into remission for a couple of years with few side effects. However, during one infusion she had a severe reaction, similar to anaphylactic shock, and her body rejected the drug.
At this point, it seemed that Alison was out of options. After 20 years of fighting a ruthless and unforgiving disease — often while living away from family — she was at a crossroad: go back to a drug that was worse than the disease, or risk taking a drug that was too weak to effectively fight the disease. Thankfully, Alison was prescribed a new biologic drug and it has successfully put her in remission with only the occasional flare. Her symptoms are milder and the effects have been positive for the past year and a half.
Over the last eight years, Dr. Sexton and her team have been there to help and support Alison. Together they’re a team, “she’s not authoritarian” shared Alison, “Dr. Sexton works with me when making difficult decisions.”
Living life with an active chronic illness can be stressful, tiring and isolating. Yet Alison refuses to have this disease define her. Over the years she has gone to grad school, travelled and continues to work full time unrestricted — with Dr. Sexton and her care team always there to support her.
*Name has been changed to maintain privacy