|Year : 1977 | Volume
| Issue : 3 | Page : 27-28
IS Jain, RL Kaul, GC Jain, VP Munjal
Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh-160012, India
I S Jain
Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh-160012
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jain I S, Kaul R L, Jain G C, Munjal V P. Hyperuricemic uveitis. Indian J Ophthalmol 1977;25:27-8
Ocular manifestations ranging from conjunctivitis to severe iritis have been reported in gouty diathesis,, and monosodium urate crystals have been demonstrated in sclera, conjunctiva and cornea. However, these crystals are not deposited in uveal tract. Inflammation of uveal tract caused by gout is rare and ranges from 1 to 3 % of all uveitis. A case is reported who had an attack of iritis associated with hyperuricemia without any symptom and signs of acute gout.
| Case Report|| |
A 30 years male patient was attending out patients Department of Nehru Hospital attached to Postgraduate Institute of Medical Education & Research, Chandigarh, off and on, complaining of redness and irritation of his eyes. For this he was prescribed antibiotic and astringent drops which relieved him of his symptoms. He also complained of difficulty in doing near work. His visual acuity was 6/12 in right eye and 6/6 in left eye. He had posterior-capsular and cortical changes in right eye, and posterior capsular changes in left eye. He had marked convergence weakness for which he was given orthoptic excercises on synoptophore, with considerable relief. In August, 1976, he came to us with complaints of redness and pain in his left eye, which had developed during night. Examination revealed moderate circumciliary congestion with corneal haze, flare + + and few KPs. There were no posterior synechia. The lens showed the same earlier findings.
He was diagnosed as a case of iritis. There was no history of joint pains. He was fond of fatty and fried foods and took, moderate amount of alcohol and on previous night he had consumed a little more alcohol than usual. He was put on local betnesol drops four times a day in this eye. All investigations were normal except a persistently high serum uric acid level ranging from 9-11 mg%. In spite of such a high uric acid level he had no sign of active gout except for eye involvement. He also had no family history of gout. He was continued on local betnesol drops and for hyperuricemia allopurinol 100 mg three times a day was prescribed.
His eye condition improved remarkably and there was no trace of iritis. The patient has had no recurrence so far and there is no manifestation of acute gout.
| Discussion|| |
As in most cases of uveitis the diagnosis of hyperuricemic iritis is a presumptive one. Still some of the factors favour an association with gouty diathesis. Sudden onset usually at night following a dietary indiscretion along with high serum uric acid level.
It is suggested that though hyperuricemic uveitis is not a common condition it is worthwhile to get serum uric acid levels done is cases of iritis occuring in males with a sudden onset and running a stormy course with rapid recovery and normal appearance of eyes after the attack, with history of convergence insufficiency prior to the attack. Even though these cases may give no history of acute gout, they may account for some cases of uveitis labelled as idiopathic. Some times uveitis precedes gout by a few months, but so far, this patient has not developed gout.
| Summary|| |
A young male getting a sudden attack of iritis following a dietary indiscretion with a high serum uric acid level. The recovery was complete with no residual effect of disease.
| References|| |
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