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

2. 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

3. 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

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

7. Diagnosis
non-granulomatous panuveitis
due to leptospirosis

8. 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

9. 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

10. 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