Descriptions (1) Unilateral and recurrent (2) Typically neither posterior synechiae nor PAS (3) Mild discomfort or blurring of vision (4) Increased IOP with open angles (5) Mild anterior chamber reaction or fine white KP (6) Crises lasting from several hours to weeks (7) Normal IOP and no signs of uveitis between attack (8) Normal visual fields and optic discs PAS: peripheral anterior synechiae; KP: keratic precipitates
This case highlights some typical presenting features of birdshot retinochoroiditis underlining its association with HLA A29 as well as a few atypical features such as fine inferior keratic precipitates
and flame shaped haemorrhages.
Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates
, suggesting the diagnosis of a granulomatous disease.
In the left eye, slit-lamp examination revealed pigmented granulomatous keratic precipitates
in the corneal endothelium and iris pigments on the lens.
In the left eye, diffuse, medium-sized brownish-gray keratic precipitates
(KP) were observed in the corneal endothelium (Figure 1) and 2+ cells were noted in the anterior chamber.
As always, examination must begin at the front of the eye, ensuring there are no features of ocular inflammation, for example: conjunctival injection, keratic precipitates
, cells, posterior synechiae, iris transillumination defects or raised intraocular pressure.
(8) In patients without corneal disease, the diagnosis of herpetic AU was based on clinical findings such as recurrent unilateral inflammatory attacks in the same eye, acute elevation of the intraocular pressure (IOP) (IOP>22 mmHg) during inflammatory episodes, diffusely distributed or localized granulomatous keratic precipitates
(KPs), patchy or sectoral iris atrophy with or without transillumination defects and distorted pupil or spiraling of the iris.