Bilateral Pigment Dispersion

History of Present Illness (HPI)

A 35-year-old healthy woman with no significant past medical or ocular history is referred to the uveitis clinic by an outside ophthalmologist for “bilateral acute anterior uveitis.” She reports that her symptoms started a little over a month ago. Her eyes started to become red and very light sensitive. The referral note mentions that she was started on prednisolone acetate 1% four times a day (QID) both eyes (OU) for “4+ cells” in both anterior chambers and timolol 0.5% twice a day (BID) OU for an intraocular pressure (IOP) of 32 OU upon presentation. Since then, the photophobia and redness have decreased somewhat, she says, but not completely. The referral note goes on to add that despite some symptomatic relief, the cellularity has remained unchanged.

Questions to Ask

• Have you been hit in the head or the eyes recently?

• Have you been told that you have glaucoma, or has anyone in your family had glaucoma?

• Have you ever suffered from cold sores? Have you ever had shingles?

• Have you been ill recently? If so, how was your illness treated?

• Are you on any medications now or have you recently been on any medications that you have not told us about?

She denies any trauma to the head or eyes or any eye problems, and she has never heard anyone in her family mention any eye problems besides cataracts in her grandparents. She has no history of cold sores. She had a bad case of what her doctor told her was bronchitis, and she was treated with a 7-day course of oral moxifloxacin.

Assessment

• Acute, symptomatic pigment dispersion OU