Abstract

A 7 year old child brought by parents with c/o fire cracker injury in RE last night,decreased vision in same eye and change in shape of pupils.on exam BCVA cf 1mtr,pupil is Irregular,posterior synechiae present.Fundus shows Gr 4 vitritis.LE normal.Startedon topical steroids 2 hourly and cycloplegic.X Ray skull to rule out foreign body.USG B scan reported RE retinal detachment with vitreous exudate.on examination long standing ocular inflamation having Vitritis,posterior synechiae,peripheral patch of retinitis.Ocular Toxocariasis/Toxoplasmosis suspected.refer to infectious disease.H/0 contact with cat 1 year ago follow by fever.Toxoplasma IgG and IgM negative.empirical antibiotics also started.steroids tapered .vision improved.on F/up Pediatric rheumatology opinion taken to start methotrexate.no improvement.Left eye has vitritis.Steroid resumed but it recurred.Rheumatologist started her on Tocilizumab along with topical steroid and methotrexate.BCVA reached to RE:6/24 LE 6/9. HLAB51+ve

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