Vitritis or posterior uveitis?

[shokando]

I had a patient last week whose cc was pain and photophobia for the past 2 weeks. My first thought was anterior uveitis, however her A/C was deep and quiet. The patient has an IOL in that eye secondary to cataract formation s/p a car accident. Her IOP was 13mm hg. Upon dilation, we found pigmented cells in anterior vitreous. There were no holes, tears or any signs of R/D. Everything else was normal. We referred the patient out to a retinal specialist for evaluation and possible treatment. So my question is what's the proper diagnosis for this patient?

Thank You!

[kholden]

I was diagnosed with west nile 3 years ago, hit me pretty hard after a year I was then diagnosed with posterier uveitis, I was sent to reumatologist with no luck in that area, for two years I only had small bouts of pain and with injections and pred forte alot.
late last year I developed baisler artery migranes.
Last week while at work, I went blind in my left eye 20/400, went running out of work to the eye dr, he found a visi strand and then when he dialiated the eye found a very large catarac on the lense. Now they tell me I need surgery but the surgon here is very reluctant to do as there is no prev history of cases to go by,

Any suggestions?

[Joan M Pernoud, MD]

If you are sure of your anterior segment results and I assume the retina specialist will rule out any indolent vitritis, I would relook at the cornea with staining and under the upper lid. You might wish to r/o an intraocular foreign body with a CT scan as there could be history the patient does not recall regarding exposure to such. I suppose it could be migrainous. Otherwise, one might look for signs of meningeal irritation.