History of Present Illness
A 34-year-old African American female complains of decreasing vision in both eyes (OU) over the past year, with no previous history of ocular disease. She denies ocular redness, pain, or photophobia. However, she does complain of a dry mouth and mild dyspnea when walking up four flights of stairs. Her past history is otherwise unremarkable.
Exam
| OD | OS | |
|---|---|---|
| Visual acuity | 20/60 | 20/40 |
| Intraocular pressure (IOP) (mm Hg) | 12 | 10 |
| Sclera/conjunctiva | No injection. Solitary nodular granuloma in inferior fornix | No injection |
| Cornea | Multifocal keratic precipitates (MF KP) ( Fig. 30.1 ), with interstitial keratitis inferiorly | Diffuse MF KP with mild interstitial keratitis |
| Anterior chamber (AC) | 2+ flare, 3+ cell | 2+ flare, 2+ cell |
| Iris | Posterior synechiae intermittently for 360 degrees | Posterior synechiae at 3:00 and 7:30 |
| Anterior synechiae from 4:00 to 7:00 | ||
| Lens | 3+ PSC | 1+ PSC |
| Vitreous cavity | 3+ vitritis with string of pearls | 2+ snowball opacities |
| Retina/optic nerve | Granulomas on optic nerve head ( Fig. 30.2 ), with retinal periphlebitis and candle wax drippings ( Fig. 30.3 ) | Mild swelling of optic nerve head with periphlebitis |
Mutton fat KPs diffusely distributed over corneal endothelium.
