Consultant, Uveitis Service Leptospirosis Dr. Rathinam Sivakumar HOD - Uveitis Services Dr. Radhika. T Consultant, Uveitis Service Dr. Vedhanayaki Rajesh

Ocular History 27 year old male OS: defective vision & floaters since 6 months pain and redness – on & off occupation: agriculture H/o exposure to rats

First Presentation VA: OD 6/12, OS 6/6 IOP: OD 14mm Hg; OS 10mm Hg OD: non-granulomatous KP's, AC 3+cells; hypopyon AVF – vit. haze 2+ with vit. membranes fundus: dense vitritis, hyperaemic disc, vasculitis OS: quiet eye

Investigations Routine baseline investigations (TC,DC,ESR,Mantoux and TPHA) within normal limits Leptospirosis microagglutination test (positive in 1: 100 dilution)

Diagnosis non-granulomatous panuveitis due to leptospirosis

Therapy Steroid eye drops– tapering therapy Oral Doxycyclin (100mg) twice/day for 10 days Oral Prednisolone tapered weekly from 40mg/week to 10mg (4 weeks) Inj. Triamcinolone acetonide 0.5cc given

Follow Up – After 1 Month VA: OD 6/6, OS 6/6 IOP: OD 17mm Hg; OS 17mm Hg OD: AC – Quiet; AVF – Occ. Cells OS: Quiet eye

Conclusion - Leptospiral Uveitis water borne spirochaetal systemic infection spread from animal to human with increased risk among people exposed to leptospiral contaminated water or soil systemic picture can vary from hepato-renal dysfunction to mild fever with arthralgia non-granulomatous panuveitis with hypopyon, membranous vitreous opacities, papillitis and vasculitis are significant ocular signs carries good prognosis