Systemic Diseases In Young Patients Manifesting As Ocular Pathologies

The purpose of this case series is to highlight the diagnostic and therapeutic challenges in 4 ophthalmic cases: granulomatous scleritis with secondary retinal detachment and suspected choroidal melanoma in a young patient with sarcoidosis, young male with cavernous sinus thrombosis and intracranial hypertension, post-COVID young female with viral seropositivity and retinal complications, and a young male with ocular hemorrhage due to thrombophilia. Each case underscores the complexities of diagnosing and managing ocular conditions in the context of systemic diseases.

cataract, sarcoidosis, sleritis, covid-19, thrombophilia

1. A 26-year-old female initially presenting with retinal detachment and suspected choroidal melanoma was diagnosed with sarcoidosis after laboratory tests and imaging. 2. A 21-year-old male presented with sudden diplopia, left-sided headaches, and pulsating pain for several days. His visual acuity was 20/20. Examinations revealed bilateral papilledema and stasis optic neuropathy. 3. A 25-year-old female with post-traumatic and congenital cataracts and a chorioretinal lesion in the left eye was evaluated for viral reactivation, with serology tests guiding management. 4. A 30-year-old male with significant visual impairment from posterior segment hemorrhages was diagnosed with thrombophilia, suggesting coagulopathy as the underlying cause.

1.After the treatment the right eye showed resolution of the choroidal granuloma preserving stable visual acuity. The left eye had retinal detachment and persistent lesion though it was reduced in severity with systemic corticosteroids and methotrexate. 2: Started a treatment including hyperosmotic agents (mannitol), systemic antibiotics, acetazolamide, and citicoline-his symptoms gradually improved. 3: serological testing revealed positive results for multiple viral infections.Examination showed reduced VA (VOD: 20/63, VOS: 20/200), a chorioretinal lesion in the left eye, and irregular ILM on OCT. 4:The patients ocular hemorrhage was attributed to an underlying coagulopathy, emphasizing the necessity of detailed systemic investigations,

Each of these cases demonstrates the necessity for a comprehensive, multidisciplinary approach to diagnosis and management, ensuring optimal patient outcomes. The intersection of ophthalmology with systemic conditions shows the importance of detailed history taking, advanced imaging, and systemic investigations in patients presenting with complex ocular findings.