case uveitis.pptx

case uveitis.pptx

• 1.
  CASE PRESENTATION PRESENTER- DrSADYAJA SMITA UNDER GUIDANCE OF- DR. ABHA SHUKLA
• 2.
  PATIENT DETAILS • Name:Ramwaran s/o Roopkishor • Age/Sex: 43 years/Male • Address: BHIND,Gwalior • Occupation: Shopkeeper
• 3.
  PRESENTING COMPLAINTS • C/oredness and pain in both eye 3 months back • C/o Dimunition of vision in both eyes since 1 month
• 4.
  HISTORY OF PRESENTINGILLNESS • The patient presented in our opd with redness in both eye 3 months back which was acute in onset and gradually progressive in nature associated with watering in both eye which was relieved on medication. • The patient developed diminution of vision in both eyes since 1 month which is insidious in onset, gradually progressive and not associated with floaters, micropsia, macropsia, metamorphopsia, photopsia, dyschromatopsia, or nyctalopia.
• 5.
  PAST HISTORY • h/orta 6 yrs back when he underwent surgery for right tibia fracture • c/o back stiffness since 4 years • No c/o flu like illness, chronic cough, shortness of breath, oral or genital ulceration, burning micturition, skin lesions, significant weight loss, chronic diarrhea, tinnitus, or vertigo. • The patient did not give any history of previous ocular trauma, ocular surgery, or any history of intake of immunosuppressants, or i/v drug abuse.
• 6.
  MEDICAL HISTORY • Nota k/c/o hypertension, diabetes mellitus, tuberculosis, bronchial asthma, epilepsy. PERSONAL HISTORY • The patient denied any history of close contact with animals, bathing in the river, or consuming uncooked meat. FAMILY HISTORY • No history of similar illness in the family.
• 7.
  On Examination • Thepatient was well oriented to time, place and person; had average built and stature with normal appearance. • All the vitals of the patient were within normal limits. • No signs of pallor, icterus, cyanosis, clubbing, lymphadenopathy, pedal edema
• 8.
  RIGHT EYE LEFTEYE VA 6/36 PH 6/12 6/24 PH 6/12 Orbit Normal Normal Lids Normal Normal Position Primary Primary Movements of the globe Full Range Full range Conjunctiva Normal NASAL PTERYGIUM GRADE 2 Sclera White White Cornea MILD HAZY, sensations normal MILD HAZY, sensations normal AC NID NID, Pupil CCRL+ CCRL+ Lens Opacity 1+ Opacity1+ IOP BE 16 mm Hg with GAT (10/07/20 at 10 AM)
• 9.
  SLIT LAMP EXAMINATION •BE- MULTIPLE MUTTON FAT KPs in arlt’s triangle • AC cells grade 2 • Aqueous flare grade 1 • Koeppes nodule on pupillary border
• 10.
  OD OS
• 11.
  FUNDUS EXAMINATION BOTH EYE-Red glow seen. Media mild hazy(vitreous haze grade 2), Disc- size, shape, colour - normal, margins normal, general fundus –mild tessalation, vessels in general fundus- normal Foveal reflex absent.
• 12.
  Probable Diagnosis- RECURRENTBILATERAL GRANULAMATOUS ANTERIOR UVEITIS DIFFERENTIAL DIAGONOSIS TUBERCULOSIS SARCOIDOSIS LEPROSY SYPHILLIS VKH TOXOPLASMOSIS
• 13.
  TREATMENT GIVEN • E/DMOXIFLOXACIN+DEXAMETHASONE 6 TIMES A DAY • E/D HOMATROPINE TWO TIMES A DAY • E/D CMC 4 TIMES A DAY • TAB prednisolone 40mg tapered in 5 days • TAB MVBC ONCE A DAY
• 14.
  Investigations • Blood investigations-CBC, ESR, CRP,RA FACTOR • SEROLGY- VDRL, SEUM ANCA, SEUM ACE • MONTOUX TEST, CBNAAT , INTERFERON GAMMA ESSAY • Radiological investigations-CHEST XRAY, SACRO-ILIAC JOINT XRAY • Immunoassay/HLA- HLA-B27 TYPING