ACUTE ANTERIOR UVEITIS WITH SURPRISE CATARACT. A CASE REPORT.

To describe a serious complication associated with acute anterior uveitis after and clinical importance of fundus examination before cataract surgery. Factors that have to be taken into consideration.

Ophthalmology department, Hospital Universitario San Cecilio, Granada, Spain.

Observational case report. We portray the findings of the fundus examination and OCT. We also used the PubMed database to find other prospective or retrospective studies.

We report a clinical case of a 65-year-old female referred to our department from emergency room with signs of an acute anterior uveitis in the left eye. In the past, the patient had recurrent episodes of keratouveitis in her right eye which caused a central vascularized corneal leukoma. Left eye had a best corrected visual acuity of 5/15. A slit-lamp examination showed many keratic precipitates, anterior chamber cells and moderate nuclear opacity of the lens. IOP was 21 mmHg and posterior pole was not examined. Dexamethasone drops, acyclovir ophthalmic ointment and atropine 1% drops were prescribed. Patient responded well to treatment. After multiple recurrences over one year, we tried to explore fundus but it was not possible due to nuclear and posterior subcapsular opacity of the lens. The ultrasounds showed hyaloid detachment and it was decided to perform a phacoemulsification cataract surgery. After that, retinal and choroidal necrosis and fibrous proliferations anchored to the optic nerve and to the nasal arcades were found. Posterior vitrectomy was performed and intraocular gas was injected into vitreous cavity. Progressive outer retinal necrosis with macular affection and optic atrophy was diagnosed. Post-surgical visual acuity in her left eye was amaurosis and no signs of retinitis have been found until the present day.