[gstrong7078]

I am seeking assistance to help resolve the seeing problems of a 61 year old colleague being treated for longstanding essential hypertension. His hypertensive condition was diagnosed when he was 18 years old and he began taking antihypertensive medications in his late twenties. Initially, he was prescribed propranalol (Inderal), but this was discontinued because of various side effects (including recurring flu symptoms, sore joints, and anterior uveitis), which were speculated to be associated with this medication. Indeed, these conditions abated without recurrence when he switched to a calcium blocker alternative, Nifedipine (Adalat). His recurrent iritis began again 18 years later when he began multiple drug therapy. His first cocktail regimen consisted of a combination of Indapamide, Nifedipine, Lisinopril and Losartan. When his iritis flared up again, he was switched to a combination of Clonidine, Lisinopril, and Amlodipine; both with and without an accompanying diuretic. Unfortunately, his bouts of iritis persisted. His current medications are Nifedipine XL, Doxazosin, and Tenoretic (50mg Atenolol + 25 mg Chlorthalidone). He continues to experience frequent bouts of anterior uveitis, for which he uses Pred Forte drops. I understand that the vasodilatory effects of his medications are additive and that they have been shown to exacerbate arthritic/arthralgic symptoms in susceptible persons, but we’ve been unable to find any specific mention of anterior unveitis as a possible adverse ocular side effect. Extensive diagnostic testing has ruled out auto immune disease or any other contributing factors in this case. Has anyone had any similar experience with these or other antihypertensives? Or seen anterior uveitis related specifically to long term chronic medication with drugs of any type that are not normally associated with anterior uveitis? Or is anyone familiar with any relevant clinical information in this regard?