This acute, chronic or chronic-recurring inflammatory disease involves the vascular membrane of the eye (uvea). The corresponding changes that may occur are iritis, cyclitis and choroiditis, but sometimes also combined irido-cyclitis or panuveitis.
The protocol is similar to that of skin diseases (without the local applications of ointments, but with careful skin protection), and usually patients reach up to 4 hours of daily sun exposure.
In the principal publication on the Israel study , the authors reported in 1988, subjective improvement in the patient's sight, durable positive and detectable effect after 6 months, and a significant drop in the incidence of inflammatory episodes in the year after the 3-week stay at the Dead Sea.
The authors related these favorable effects to the systemic immunosuppressive effect of the UVA on the Dead Sea shore, and recommend this physiological method of immunosuppression in the treatment of chronic uveitis.
In order to answer the numerous questions that are arising from this type of treatment for uveitis, we reproduce here a part of one of our publications on this topic.
Uveitis Treatment at the Dead Sea
Update on Frequently Asked Questions - June 2002
M Harari, V Chenkin, DMZ Medical Center, Ein Bokek, Israel
1. What are the special climate conditions of the Dead Sea?
The healing properties of the Dead Sea area have been attributed mainly to the high mineral content of the Sea, and to the haze surrounding it, to the attenuated ultraviolet B (UVB) radiation, to the increased atmospheric oxygen concentration and to the relaxing capability of its bromides.
2. Since when have Uveitis patients visited the Dead Sea?
In 1984, some observations were done on the positive effects of natural light treatment for Uveitis. The first pilot study carried out by Manthey, was published in 1988 with one-year follow-up study after Dead Sea therapy. Since then the number of patients looking for uveitis treatment at the Dead Sea has increased each year.
3. What medical service and natural medications can you offer to Uveitis disease patients?
At arrival, a medical history is carefully recorded by the nurse in attendance, as well as the vital signs, the Body Mass Index and the Body Surface Area. The patient is then examined and instructed by a senior physician, in terms of sun exposure, Dead Sea water bath, sun protection, oils, creams or other medications for uveitis if needed. After the medical examination and the evaluation of the disease severity, a personal treatment schedule is assessed (for sun and Sea), and explained. Other medications for uveitis taken at home are also checked and usually maintained. In the next several days, the patient is examined by a senior ophthalmologist, and all relevant data recorded in a personal data chart. Follow-up visits and consultations by both physicians are required and are always done at the end of the therapy, in order to evaluate the changes in the eye status. During the treatment, the patient consults with the nurse or is examined at any time by the physician. After the final examination and evaluation of the short-term results, a medical report is written, for both the physician at home and the patient.
4. Why do you think that a stay at the Dead Sea may be helpful for Uveitis-patients?
Since the first paper in1988, there are many testimonials on the beneficial effects of Photoclimatherapy at the Dead Sea for Uveitis. In 1998, the results of a long term study of 26 involved eyes definitively substantiated beneficial effects of a 4-6 weeks treatment at the Dead Sea. They include:
* Reduction of the medications needed,
* Diminution of the acute episodes of flare-up,
* Improvement of the visual acuity,
* Reduction of the macular edema and
* Improvement of the general feeling.
These long term effects were so amazing that they induce new studies upon UVA-1-Phototherapy, as done in Germany. However, this last option necessitates 40 sessions over a 4-month period and is not always available. A 4-week treatment at the Dead Sea appears to be an attractive alternative for endogen Uveitis, and free of acute or chronic side effects.
5. How would you describe a normal day for such a patient at the Dead Sea?
The sun bathing sessions are divided in two periods, morning and afternoon, in which the sun exposure is allowed (hours are depending of the month of the year). Outdoor activities are freely allowed, but only in the shadow or under sun protection. Bathing in the Dead Sea is prescribed before sun exposure, and does not exceed 15-20 minutes twice a day. The individual schedule treatment protocol given after the first medical consultation has to be followed strictly by the patient, in order to prevent eventual overexposure to the sun. At the beginning of the stay only a few minutes of sun exposure is prescribed and the maximal exposure period is 4 hours a day.
6. Do people have to use sun protection?
If redness appears in some parts of the body, they should be covered while in the sun and a sun protection lotion applied. After the recommended sun exposure times, the patient has to protect himself from sun radiation. Sun glasses are recommended, as well as a broad-brimmed hat.
7. How long should a patient stay at the Dead Sea Medical Clinics?
As a rule, a stay of 4 weeks is recommended for each patient. The statistical data available on uveitis treatment time showed that 4-week is the optimum period. However, upon request of the physician in charge, a one or two week-extension may be appropriate in order to prolong and maintain the best therapy results. If the period of time is too short improvement may not occur, since the targeted quantity of UV radiation cannot be easily reached.
8. Do you suggest repeated stays?
Experience shows that repeat treatments help to reduce the uveitis activity. It is recommended that as a rule there should be at least 3 treatment programs in 5 years. Each case needs to be evaluated individually and children or newly diagnosed Uveitis cases require more visits than adults.
9. How would you describe the goal of a stay at the Dead Sea for Uveitis-patients?
See Question #4.
10. What else can a patient do in your resort besides sun bathing?
Numerous possibilities of fun and entertainment are available at the Dead Sea. This region is well known for its historical and geographic uniqueness aspects. Hotels and spas provide a choice of activities, indoor and outdoor. Information may be obtained upon request.
11. Why Patients and Physicians do not use more than today the Dead Sea therapy?
The key-word for this answer is "Information". We all need to work together in order to bring more details, reports and explanations upon this natural treatment.
||Uveitis - neue diagnostiche und therapeutische Aspekte. Verlag Berstelsmann Stiftung, Götersloh, 1988.
||Manthey KF, Danielmeyer F. Modification of the course of chronic intraocular inflammation by sunlight (Israel study). Klin Monatsbl Augenheilkd 1988; 193(1):44-7.
||Danielmeyer F, Manthey KF. Heliotherapy in iridocyclitis and intermediate uveitis. Fortschr Ophthalmol 1989; 86(5):478-81.
||Shani J et al. Indications, contraindications and possible side-effects of climatotherapy at the Dead Sea. International Journal of Dermatology, 36:481-92, 1997.
||Kuschelevsky A et al. Safety of solar phototherapy at the Dead Sea. Journal of the American Association of Dermatology, 38:447-52, 1998.
||Künstliches Licht - eine Therapie bei endogener Uveitis? : Evaluation einer neuen Methode der UVA-1-Ganzkörperbestrahlung.
Dr. Dorothee Baumgart, Dr. Sabine Mende. Verlag Bertelsmann Stiftung, Gütersloh, 1999.
||Hengst W. Neue oder subtropische Klimatherapie am Toten Meer. Tips für die Praxis. Augenarzt. 6. Heft. October 2000.
||Harari M. Demographic evaluation of successful treatment of Uveitis at the Dead Sea, a 10-year report. In press.
© Dr. M. Harari, 2002
||Dead Sea Clinic for Skin Diseases: Treatments of Psoriasis, Vitiligo etc.