TB Uveitis: 48 y.o. AA woman with c/o of photophobia, tearing, and eye pain OU.


CC:
48 y.o. AA woman with c/o of photophobia, tearing, and eye pain OU.
HPI:
48 y.o. AA HIV(+) woman with 1 month of gradual photophobia, tearing, and eye pain OU. She was started on anti-retroviral therapy (ART) 1 year ago when her CD4 count was <50. After starting ART, her CD4 count has been above 250. She was doing well until one month ago when she c/o of increasing redness and eye pain OU. On presentation, she was photophobic.

No c/o of fevers, chills, or night sweats. No joint pains. No shortness of breath. No other complaints. No recent exposures to illnesses.
PMH:
HIV(+) on antiretroviral therapy. TB test performed one year previous was negative, but the candida control was also negative. No previous ocular problems.
Exam:

•Best corrected visual acuities: 20/50 OD and 20/40 OS.
•Pupils: irregularly shaped (see photo), reactive, no RAPD.
•IOP: normal
•EOM: full OU
•VF: normal
•DFE: retina exam notable for normal macula, vessels, and periphery OU. No vitreous cells.
•SLE: notable for marked conjunctival injection OU, ciliary flush OU, 2+ cell/flare OU, and large keratic precipitates (KP) on the corneal endothelium OU. There was central posterior synechia around the pupil margin OU.
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Full Details with Pictures:

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