panuveitis

1. Case Presentation
By:- Dr Sudhanshu Shekhar
1st yr. PGT
Dept. of Ophthalmology, MGMMC

2. Chief complain
A 55yr old patient named Mirshad Alam, came from Purina district
in eye OPD with c/o of :-
Diminution of vision both eye since 3 months, associated with pain
and redness of both eye.

3. History of present illness
• Pt was apparently alright 3 month back then he developed pain in Rt eye
gradual in onset and progressive in nature.
• Pain was associated with B/E redness, photophobia, reduced vision(RE>LE).
• No h/o joint pain
• No h/o asthma, GIT symptom.
• No h/o haematuria or urethral discharge
• No h/o skin conditions

4. Past history
• No such similar complaint in past
• No h/o DM/HTN/Trauma/allergy/asthma
• No h/o any other systemic illness(RA/TB/HIV/Sarcoidosis…)
• Patient was taking 1 eye drop from local medicine shop.

5. Family history
• No significant family history given by patient.

6. On gen physical examination
• No pallor
• No icterus
• No cyanosis
• No clubbing
• No lymphadenopathy
• No oedema
Vitals:Temp.-98.8*F
BP- 130/80mmhg, PULSE- 70 bpm

7. Occular Examination
Right eye Left eye
Visual acuity PL+ve HMCF
Lid normal normal
Conjunctiva Mild Congestion +nt Mild Congestion +nt
Cornea Hazy, fine KP’s Hazy, fine KP’s
Ant. chamber Deep, flare+, cells++ Deep, flare+, cells++
Iris NP NP
pupil Post synechiae,
constricted round pupil
Post synechiae broken,
anisocoria(RE>LE pharmacologically)
Lens IMSC IMSC, post capsular exudate +nt
Extra-occular movement Full Full
Lacrimal apparatus(ROPLAS
test)
Negative Negative
IOP 14 16

8. Right eye Left eye

9. Slit lamp examination
Rt eye Lt eye
Pupil constricted
R/E 360 post synechiae not broken
Fundus cant be seen
Pupil dilated >3/4
L/E 360 post synechiae were broken
Media hazy
Exudates on post. capsule of lens
Vitritis 3+

10. B-SCAN
LEFT EYE
RIGHT EYE

11. Investigation
• Blood for CBC,ESR,FBS,PPBS,HBA1C, uric acid level
• ACE level
• Serology( for syphilis, toxoplasmosis)
• RA factor
• Mantoux test
• HLA tissue typing
• Chest X-ray(PA view), X-ray of sacroiliac joint

12. Provisional diagnosis
•Bilateral Pan-uveitis

13. Treatment given:
• E/D Predforte 1 x 10 times/day
• E/DTopin 1 x 3 times/day
• TabWysolone 60 mg 1tab OD 5days
• Review after 5 days or sos.
Both eye