A 25year old male presents with painless sudden loss of vision, ocular and systemic examination is not contributory. What is probable diagnosis
Ans is Eale's disease Both Eale's disease and Retinal detachment are causes of painless sudden loss of vision, however Eale's disease is a much more common cause than RD in a young male. Ocular and systemic examinations in both the conditions may be normal.Eale's diseaseIt is a disease of young adult males, who otherwise are healthy, in developing countries (especially India).It is an idiopathic inflammation of peripheral retinal veins; characterized by recurrent vitreous hemorrhage.(Periphlebitis leads to obliteration of the affected vessels. Hypoxia leads to neovascularization which lead to recurrent vitreous hemorrhage)The etiology is unknown. Hypersensitivity to tuberculin protein has been reported, however no clear relationship to tuberculosis has been found.Usually bilateral.The common presenting symptoms are sudden appearance of floaters or painless loss of vision.The vitreous hemorrhage clears spontaneously, but after a few recurrence the hemorrhage may organize, and may cause fractional retinal detachment or secondary glaucoma.Treatment:systemic steroids in early vasculitis stageLaser photocoagulation for abnormal vessels is used in neovascularization stagevitreoretinal surgery is required for marked vitreous traction threatening the macula.Causes of sudden, painless loss of visionUnilateralBilateralSubluxation or dislocation of lensVitreous hemorrhageRetinal hemorrhageRetinal detachmentRetinal vascular occlusionExudative age-related macular degenerationPosterior uveitis Diabetic retinopathyGrade IV hypertensive retinopathy with macular star Atypical optic neuritis Toxic optic neuropathy Bilateral occipital infarction
Retinal detachment
Eale's disease
Glaucoma
Cataract
Vitreous Haemorrhage Vitrectomy