Dr. Gopal Damani., MBBS, MS OPHTHALMOLOGY, FELLOWSHIP OCULOPLASTIC SURGERY, FVRS, CERTIFICATE PROGRAM IN PHACOEMULSIFICATION
Medical Case Details:
An 18-year-old male patient came to my outpatient department with a sudden diminution of vision in the left eye along with photophobia. It was painless and not associated with redness or watering. There is no trauma and no significant history like personal or family history. On local examination, the right eye was 6/6, N-6, and had normal anterior and posterior segments. The left eye counted finger at 1 meter, Mutton Fat Granulomatous Keratic Precipitates involving the whole cornea were seen, pupil sluggishly reacting, and iris color was visible hence minimal cells and flare. On dilation, annular posterior synechiae were visible. The retina was not visible. The patient was sent for evaluation of Sight Threatening Panuveitis of the left eye.
Patient followed up with investigation reports-
ESR was raised, IgG antibodies to Toxolasma Gondi, Rubella and Cytomegalovirus were positive but their IgM antibodies were negative.
Rest all investigations were normal and patient was Immunocompetent.
Patient was started with topical Prednisolone in tapering dose from 6 times to 1 time tapered every week, Homatropine BD and Timolol BD.
case was discussed with Physician and patient was started with Oral Clindamycin 300 mg qid and Septran ( Pyrimethamine 160 mg + Sulfa methoxasole 800mg) BD, Prednisolone 60 mg along with Pantoprazole and Calcium supplements for 1 week and will be reviewed then.
why not increase frequency of steroids and also add oral steroids as per body wt. since we have gotten an antibiotic cover now. How about even considering topical Nsaids.
if patient is immunocompetent and sero negative, u can consider.
so i m guessing also there is lot of vitritis.
can even consider a pst injection of triamcinolone.
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