Posterior uveitis

By

HANY EL-DEFRAWY

• 19 year old Caucasian man complained of seeing floaters for 13 months in left eye.

• Painless deterioration of vision for 10 months in left eye.

• No history of fever , weight loss, chronic cough, joint pains, skin rash, mouth ulcers

• No history of TB contact

• No history of animal contact

• BCVA 6/4, 6/60• Anterior segment +1 cells• Fundus: Slight vitreous hemorrhage in left eye• Swollen optic disc.• Cystoid macular edema.• Subretinal fibrosis• Multifocal chorioretinal scars• Shallow exudative RD• ERM

Investigations• FBC• ESR• Syphilis • LFT, U and E, Coagulation, ACE• U/S liver: echogenic lesion• Serology: Toxocara,

Cysticercosis,Leishmaniasis,Lyme disease HBSAg, Filariasis, Hydatid

• Infectious mononucleosis screen negative.

Management

• Orbital floor triamcinolone 40 mg

• CMO responded very well

• Patient developed steroid response glaucoma

• Alphagan and cosopt BD was prescribed for the left eye.

• Flare up of inflammation, AC cells +2, Bio score 2, swollen hyperaemic optic disc,

• Had orbital floor triamcinolone.

parasitic eye disease

• Zoonatic diseases

• Contact with infected animals

• Consumption of raw meat

• Toxoplasmosis (Acquired, congenital).• Toxocariasis (T Canis).• DUSN (Baylisascaris procyonis)• Onchocerciasis (Onchocerca volvulus)• Cysticercosis (Cysticercus cellulosae)• Ophthalmomysis • Echinococcosis (Echinococcosis)• Amebiasis