History of Present Illness
A 42-year-old female with past medical history of biopsy-proven interstitial nephritis since 2008 presented for the first time 2 years after the onset of nephritis to the eye clinic with anterior uveitis that started 5 months ago. She was treated with systemic corticosteroids (CS). The treatment was stopped a month ago, and 3 days later she noticed worsening of vision ( Figs. 11.1 and 11.2 ).
Exam
| OD | OS | |
|---|---|---|
| Visual acuity | 20/40 | 20/25 |
| IOP | 15 | 15 |
| Sclera/conjunctiva | Minimal ciliary injection | Minimal ciliary injection |
| Cornea | Small granulomatous KP in lower half (see Fig. 11.1 ) | Larger granulomatous KP in lower half (see Fig. 11.2 ) |
| Anterior chamber (AC) | Deep, 1–2+ cells | Deep, 2+ cells |
| Iris | Unremarkable | Unremarkable |
| Lens | Clear | Clear |
| Anterior vitreous | +2 cells | +2 cells |
| Retina | See Fig. 11.3 | See Fig. 11.3 |
(A, B) Anterior segment photograph of both eyes with granulomatous keratic precipitate (KP).
Fundus photograph showing moderately hazy media (A, B) and snow balls in the periphery (C, D). Optic nerve and posterior pole had normal findings. There were no signs of vascular sheathing.
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