Understanding Autoimmune

After more than two decades as an optometrist, Boago Modiisane discusses how he got into the field,

Our immune system is meant how he serves the community and

to protect us, but sometimes it why tdhoeesjno’tbwcoornk taisniutesshotuoldf.uAlufitlolimmune him. diseases, such as rheumatoid arthritis or lupus, can TELL UaSffeActLIhToTwLEouBrITimmune system ABOUrTeYspOoUndRsStEoLeFven healthy organs.

Sun Healthcontinues chat with My name is Boago Modiitsane, I

Consultant Rheumatologist ,Dr come GfraoomneDMitalohtalolatpo yleearannmdodreidabmouyt primarhyoswcrhhoeoulmaantdolsoegciostnsdhaerlpypsacthieonotls at St Pwaithriacukt’soiPmrmimunaerydiSsecahsoeso.l and Madiba Secondary School respectively. I am married and have three girls. I currently run my own private practice in Mogoditshane, Eye Care Optometrists!

YOUR CAREER IN OPTOMETRY: DID YOU HAVE AN EPIPHANY MOMENT OR WAS IT ALWAYS PART OF THE MASTER PLAN?

Boago Modiisane: First your direction. She suffers from What symptoms polymyositis. are associated with Explain to us what the condition? polymyositis is? Is it a form of arthritis?

of breathing machines for adequate oxygenation.

The lung tissue may be affected resulting in lung fibrosis and subsequent shortness of breath.

Patients with Polymyositis may Symptoms of Polymyositis include from Lobatse and Gaborone coming visual system and in the preventioanlsof have some joint pains with or

easy fatiguability such that tasks that without inflammation (pain, swelling, to do outreach in Hukuntsi Primary are normally eye disease easy, prove and injury. to be exhaust- The ophthalmologist

Early morning stiffness, loss of joint Hospital and I told myself that one ing. There may is be the muscle medically ache (myal- trained specwieailgisht

function) day I will have to be counted as one gia), lwoshsoancdanmadlealisivee(gretnoetraallleyye carThe: e heart muscle may be involved ofPeoyleymcayroespitrisofiessosinoenoaflstihneBcotnsdwi-ana.feelinpgriumnwareyll,)secondary, and tertiary canardebecome inflamed. This may result tioDnsucrainllegdoIudriotpimatheisc, cInaflraemermgautoidryance It smearyvibcesd(iffii.ec.uvltisciloimnbsienrgvsitcaeisrs, ,conitnapcattients complaining of palpitations Myopathies. was not as The developed other conditions as it is be- today, gettilnegnsueps,freoymeeloxwamcihnaairtsi,ocnasr,rmyinegdicaloerycehest

pains and other symptoms ing Dermatomyositis and Inclusion heavy objects, raising arms and even indicating impaired cardiac function we had to do some research on our care, and surgical eye care), diagnose

Body Myositis. They cause muscle lifting the head from the bed or getting The symptoms of Polymyositis may own regarding careers. So, after some out of general bed disease of the body and treat inflammation. These conditions are occur insidiously over time getting AreusteoiamrcmhunIesientntlaetudref.oProlOympytoosmitiestry. Paoticeunltasrmmayanalisfoeshtavteiodnifsfiocufltsyystewmoircse as the disease progresses iGs odviffeerrnemnteiantetdhfardomoffDeerremdatmome ysoc-hol-swaldloisweiansge-st.hey may complain of sairtsishbipy tohedaobsdeenncetisotfrryasbhutfoIucnhdoinse tosensatioOnpotfofmooedtrgiesttiinsgastupcrkiminatrhyehealthcare Dsteicrmk attoomyyosfiirtist. choice - Optometry. upper throat, professional and there of may the also eye and be visual

nasal regurgitation of fluids. This results AfPtoelrycmoymospilteistinisgcmhayrapcatretriozneed BbSyc at systems who provide comprehensive inflammation of muscles with resultant in risk of aspiration of food and University of Botswana, I was admit- aspiration eye and Pneumonia. vision care, The which speech includes muscle weakness. The muscles ted at the University of Auckland in may refraction also be nasal. and These dispensing, symptoms are diagnosis normally affected are those around tNhewshoZueladlearns,dhitpos,ptuhrigshuseaOndptnoemcke.try.duetaonindvomlvaenmaegnetmofeonetsoopfhadgiesaelasneds of the ThUpeomnucsoclme pwleeatkinoens,sIiscapmroexibmaaclkanhdome phareyynegeanl mdutshcelesr,eahnadbtihleityaitniodincaotef condiasmoretisoenvesreofditsheeasev.isual uasutahlley fisyrmstmMetorticsawl.anOathtoergmraudsuclaetse systems. Primary that an Optometrist. can be affected I include have also those done of a Involvement care optometry of respiratory is complete musclesthat eye and the upper oesophagus and phanynx. is those of the diaphragm and Diagnosis of Polymyositis is based Masters Degree in Public Health with vision care that highlights the importance on Clinical presentation and investigapreventtiions,

Polymyositis is a rare condition that rib cage, results in weakness of these

University of Liverpool in the UK. muscles with of weak optometry respiratory in effort . Early diagnosis and treatment is affects females more than males. It uOsnuamllyy areffteucrtns ahdoumltes ifnro1m99t6h,eI3jordinedand theaplathtieendt uwcilal tcioomnp, lhaienaoltfhshporrot-moteiossnen,

tial fBooraggoodMcoldiniiiscanl oeutcome. dtheceadperiovnawtearsdescwtiothr a npedaksuinbcsideeqnucentlynesshoef ablrtehatmh anindtmenaaynecned, udpiahganvoinsgis, treaTt-he major diagnostic criteria for

respimraetonrtyafanildurreerheaqbuirlintagtaiossnis,tacnocuenselPinogly,myositOisn/ Daedrmaya-ttom-dyaoysitbiassiis fsrtoamrteagdem40y-6p0riyveatres.practice in 2000. and interdisciplinary consultation.

Opticians are primary health care professionals who provide vision care through refraction and dispensing of optical aids such as spectacles.

How is it diagnosed? Breakdown the tests that one would have to undergo?

called the Bohan and Peter Diagnostic Criteria. These include:

Proximal muscle weakness- Weakness of muscles of the shoulder/ pelvic girdle and neck muscles

Elevated serum muscle enzymesThese are markers of muscle inflammation, and they are elevated in patients with active disease

Abnormal Electromyography resultsThe body makes muscles contract by electrical discharges from nerve endings at muscle membranes. An inflamed muscle will result in an altered electrical activity

Muscle biopsy- A sample of the inflamed muscle is taken and analyzed in the lab to identify characteristic features of muscle inflammation seen in Polymyositis

Polymyositis is classified as ‘definite’ in the presence of 4 criteria, ‘probable’ with 3 criteria and ‘possible’ with 2 criteria.

Laboratory tests

Muscle enzymes- There are many causes of elevated muscle enzymes so these should also be ruled out when investigating a patient for Polymyositis

Antibodies-Specific antibody tests should be done as some (Myositis Specific Antibodies) help to predict clinical manifestation and prognosis

or eye inflammation. of the disease

I got in touch with you recently after one of your patients pointed me in