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Ebola Uveitis


History of Present Illness

A 28-year-old female in Monrovia, Liberia, presents with blurry vision in both eyes (OU). She has a past medical history of Ebola virus disease (EVD) diagnosed 6 months before her initial presentation. Vision loss in the right eye (OD) occurred 3 days after discharge from an Ebola treatment unit with subsequent loss of vision in the left eye (OS). Other associated symptoms include pain, light sensitivity, and tearing OU ( Fig. 18.1 ).

Exam
OD OS
Visual acuity Hand motion Hand motion
Intraocular pressure (IOP) 20 19
Sclera/conjunctiva Trace injection Trace injection
Cornea Corneal edema, keratic precipitates Corneal edema, keratic precipitates
Anterior chamber (AC) 1+ cell 2+ cell with hyphema
Iris Engorged Vessels Engorged vessels
Lens Posterior synechiae 360 degrees Posterior synechiae 360 degrees
Anterior vitreous 2–3+ vitritis 2–3+ vitritis

Fig. 18.1, Slit lamp photograph of the right eye shows a uveitic white cataract with corneal edema. There are keratic precipitates on the corneal endothelium. No chorioretinal lesions were noted in either eye.

Questions to Ask

  • Have you had recent fever, myalgia, weight loss, headache, vomiting, diarrhea, or unexplained bleeding?

  • Any recent rashes or history of sexually transmitted diseases?

  • Do you have a previous history of other infections?

  • Do you have a past medical history of any other illnesses?

  • Did you have vision problems before you developed Ebola?

The patient answers no to all these questions. She had significant constitutional symptoms 6 months ago at the time of EVD, but those have long since resolved.

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