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