"Treatment for Hla B27+ uveitis"

I have a history of autoimmune related unilateral uveitis with previous complications in my left eye which has been in remission since 2013. 

I had some ocular pain one Saturday in May in my right eye but I put this down to eye strain as there was no redness in my eye and I have never experienced uveitis in this particular eye. When I woke on Sunday my right eye was severely inflamed, I had photophobia and the pain was excruciating. I called 111 and was advised to present at the A&E department. 

I was not seen by a doctor and triaged by a nurse who called Boston Pilgrim Hospital as there was no on call opthalmology staff in Lincoln. I told the nurse to let Boston know that I was HLA B27+ and that I believed I had acute AU again. I was given cyclopentolate, no steroid drops and told I had an appointment at the Opthalmology dept on the Monday at 10am. 

When I attended the department on the Monday the member of staff was brusque and said I did not have an appointment and that this happens all the time from A&E. They told me to come back tomorrow and I said I was not happy to do that due to sight threatening issues I had had previously with AAU.  This person was not happy with my assertion that I could not wait another 24hrs for treatment and made me feel guilty as they kept saying how busy the department was. I reasserted that I was unhappy to wait another 24hrs for treatment and then I was told to return to the dept at 3:30 but I would probably have a long wait to be seen. The inflammatory changes in my eye were so severe I was given Predforte topical and instructed to use it every 30mins during waking hours and a further appointment would be made for review on Friday.  The slit lamp was not able to easily view the back of my eye so I was given OCT and booked in for a posterior sub tenon injection on the Friday as a day patient as well as instructed to increase cyclopentolate  to 4x daily and carry on with half hourly anti-inflammatories. On the Wednesday I woke up unable to see anything out of my right eye except light and, as I had to have a Covid test prior to the injection,  I made my way back to opthalmology and presented as an emergency. 

On this occasion there was no gate keeping and the staff were helpful and the opthalmologist I saw was fantastic. I was given a betamethasone subconjunctival injection within an hour of attending the clinic  as well as ultrasound b and fields tests. I subsequently received the posterior subtenon injection on the Friday. I have had no IOP tests since the Wednesday and although I am not a steroid responder I feel that I cannot approach the department again until my review in June. 

How do I feel? Disappointed that staff did not listen to me and did not seem to appreciate that as a patient with recurrent AAU I do know how quickly this condition can deteriorate, especially for me given previous experience with the department before referral to a uveitis specialist in Sheffield before 2013. I felt embarrassed and angry that I was told (with a full waiting room listening to the conversation) to return the following day with no treatment as there was no appointment made after my visit to A&E, and very upset that I had to assert myself to receive the treatment that was so very necessary due to not having been given the correct treatment at the right time, which would probably have saved the problems I now have as a result of delayed treatment- reduced vision, night blindness due to posterior involvement and no guarantee of vision restoration at the moment.