Dr.S. BALA MURUGAN

DR. HARSHA P

Abstract

Aim

To present a challenging case of recurrent post operative uveitis due to infective cause which was confused with reactivation of JIA associated uveitis

Presentation

An 18 year old boy with JIA associated uveitis operated for right eye complicated cataract presented as reactivation with panuveitis , after 7 years of cataract surgery with 1/60 vision. Meticulous anterior segment examination revealed yellowish plaque with geographic margins extending across clock hours between IOL and posterior capsule suggestive of Propionibacterium acnes. Diagnostic anterior chamber tap culture and PCR were negative. Despite negative molecular diagnostic reports, media clearing and diagnostic vitrectomy was done owing to strong clinical suspicion following which the plaque resolved and vision improved to 6/36 thereby confirming the infectious etiology

Conclusion

Molecular diagnostics are only adjuncts and not superior to appropriate clinical examination in making critical therapeutic decisions