Eales Disease

History of Present Illness

A 33-year-old male, born in Sri Lanka, who has lived in Switzerland since 2013, presents himself at the eye clinic complaining of vision loss for 4 months in his left eye (OS). He just returned from a holiday in Sri Lanka. When the symptoms started, he noticed blurred vision, followed by floaters and a feeling of pressure in his OS. At the time he was using a steroid cream due to psoriasis-like lesions on his extremities. He denied other health issues and had no systemic medications. In the past few weeks he was seen by two other ophthalmologists—the first prescribed a new pair of glasses, which did not help; the second diagnosed a vitreous hemorrhage in the OS.

The vitreous showed 1+ vitreous cells right eye (OD) and vitreous hemorrhage OS. Funduscopy OD revealed intraretinal dot hemorrhages and pronounced neovascularization elsewhere (NVE). OS showed vitreous hemorrhage, intraretinal hemorrhage, and NVE ( Fig. 26.1A and B , Fig. 26.2A and B , and Fig. 26.3A and B ).

Questions to Ask

• Have you ever had aphthous ulcers, joint pain, or thrombosis?

• Is there any history of eye illnesses in the family?

• Were you born preterm?

• Have you had radiation in the past?

• Do you have diabetes?

• Were you ever diagnosed with sickle cell disease or anemia?

The patient denies all of these questions.

Assessment

• Occlusive vasculitis with neovascularization and vitreous hemorrhage OS > OD of unknown origin