A 25year old male presents with painless sudden loss of vision, ocular and systemic examination is not contributory. What is probable diagnosis-
Eales' disease It is an idiopathic inflammation of the peripheral retinalveins. It is characterised by recurrent vitreous haemorrhage; so also referred to as primary vitreous haemorrhage. Etiology. It is not known exactly. Many workers consider it to be a hypersensitivity reaction to tubercular proteins. Clinical features. It is a bilateral disease, typicallyaffecting young adult males. The common presentingsymptoms are sudden appearance of floaters (black spots) in front of the eye or painless loss of visiondue to vitreous haemorrhage. The haemorrhage clears up but recurrences are very common. Clinical course of the Eales' disease can be described in four stages: 1. Stage of inflammation . The affected peripheral veins are congested and perivascular exudates and sheathing are seen along their surface. Superficial haemorrhages ranging from flame-shaped to sheets of haemorrhages may be present near the affected veins. 2. Stage of ischaemia is characterized by obliteration of the involved vessels and development of avascular areas in the periphery as evidenced on fundus fluorescein angiography. 3. Stage of retinal neovascularization is marked by development of abnormal fragile vessels at the junction of perfused and non-perfused retina. Bleeding from these vessels leads to recurrent vitreous haemorrhage. 4. Stage ofsequelae is characterized by development of complications such as proliferative vitreoretinopathy, tractional retinal detachment, rubeosis iridis and neovascular glaucoma. Ref:comprehensive ophthalmology AK KHURANA page no :254
Retinal detachment
Eale's disease
Glaucoma
Cataract
Vitreous and retina