Dr. Sobia Ali PPT Feb-2025 (Sarcoidosis uveitis)

This ppt is about a rare case of Granulomatous uveitis presented to us

1. CASE PRESENTATION DR. SOBIA KALHORO PGR (MCPS) OPHTHALMOLOGY DEPT. OF OPHTHALMOGY SMBBMU CIVIL HOSPITAL LARKANA

2. History 25yr old Ghulam Ali S/o Muhammad Ramzan Bhatti, Farmer by occupation R/O Qamber came in Retina Clinic on 18 th September-2024 with the complaint of; Decreased vision in both eyes for two years

3. HOPC;

4. GPE Young man of average height & built sitting comfortably well oriented time place & person with; Symmetrical head & face posture, no visible scar/mark or periorbital swelling BP 120/80 Temperature 98.6 F PR 78 b/min RR 16 b/min No skin lesion/edema or lymph notes pulpable

5. EXAMINATION OF BOTH EYES RIGHT EYE LEFT EYE VA 6/18 P.H 6/6 6/6 e BCV 0.75Ds 2/60 6/18 P.H 6/18 e BCV-1.0Ds+2.5Dc NEAR VISION N-6 N-6 COLOUR VISION NORMAL NORMAL

6. EXAMINATION OF BOTH EYES CONTD: A RIGHT EYE LEFT EYE Eyelids Normal Normal Conjunctiva Mild congestion Mild congestion Cornea Old pigmented KP on inf: corneal endothelium Old pigmented granulomatous KP on inf: corneal endothelium Anterior Chamber +1 cells VH GRADE 3 +1 cells VH GRADE 3 Iris   Normal color pattern no iris nodules or atrophy Post synechiae 360 Pupils RRR Irregular nonreactive Lens Clear Complicated cataract Extraocular Movements  Full Full IOP 34 42 Virtus Clear +1 vitritis

7. DIFFERENTIAL DIAGNOSIS;

8. Posterior Segment ​ RIGHT EYE LEFT EYE ​ FUNDUS 0.5 CD Ratio pale NRR e clear disc margins Peripheral vascular tortuosity Dull macula 0.9 cd ratio e pale NRR clear margins Peripheral vascular tortious vessels Dull foveal reflex e macular edema around 5disc diameter

9. i INVEST: SYBSTEMIC BLOOD TESTS RADIOLOGIC 1.Chest xray 2.Gallium scan 3.HRCT Chest/ PET scan 4.CT/MRI Brain 5.TRANS Bronchial Hilar lymphadenopathy biopsy

10. PROVISIONAL OCCULAR SARCODIOSIS e GLAUCOMA

11. Treatment Multidisplinary Approach involving OPTHALMOLOGIST,RHEUMAT, PULMO, DERMA, CARDIO & NEURO PT is already on TNF Inhibitors NSAIDS (Nepaphenic 0.1% E/D qid IOP LOWERING BETABLOCKERS (Timolol 0.5% bid) ALPHA AGONIST (Brimonidine 0.2% bid) CAI (Brinzolamide bid) FOLLOW UP

12. Thank You