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Unusual presentation of more common disease/injury
Case report
Transitory outward pupillary curling in a case of HSV associated acute anterior uveitis: a hitherto unreported sign
  1. Samendra Karkhur,
  2. Deepak Soni and
  3. Bhavana Sharma
  1. Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
  1. Correspondence to Dr Samendra Karkhur; karkhurs{at}gmail.com

Abstract

We report a case of herpes simplex virus (HSV) associated acute anterior uveitis in otherwise healthy 38-year-old man with an unusual finding of outward pupillary margin curling. At presentation visual acuity was 20/60 in right eye (OD) and 20/20 in left eye (OS). Intraocular pressure was 44 and 18 mm Hg in OD and OS respectively. OD revealed diffuse conjunctival congestion, stromal oedema, pigmented keratic precipitates, cells grade 3+ and flare 2+ on slit-lamp examination and diminished corneal sensations. OS was unremarkable. There was a history of three similar episodes in last 1 year. Aetiology of this recurrent acute anterior uveitis was confirmed to be HSV via DNA-PCR assay of aqueous fluid. This hitherto unreported sign associated with viral hypertensive uveitis was transitory in nature and reversible with control of anterior chamber inflammation, without leaving any permanent damage. Topical steroids and antiglaucoma were stopped, while antiviral therapy was continued for 3 months.

  • iris
  • anterior chamber
  • pupil
  • glaucoma

https://doi.org/10.1136/bcr-2020-237384

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    Footnotes

    • Contributors SK, DS and BS were involved in patient management. All authors contributed to the concept, design, manuscript review and editing. SK and DS contributed to the literature search and manuscript preparation.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.