Lupus detected through eye examination

A 23-year-old patient’s perfect vision deteriorated painlessly over the course of 10 days


A young man whose 20/20 vision deteriorated to a best corrected visual acuity of 20/40 in his right eye and 20/667 in his left eye was found to have lupus.

Associate professor of ophthalmology Sun Yat-sen University, Wei Chi, explained to OT that the 23-year-old told clinicians that he experienced a rapid, painless vision loss over 10 days without any other symptoms. The case is described in BMJ Case reports.

Images of the patient’s fundus showed bilateral multiple white patches that are typical of Purtscher-like retinopathy.

Clinicians suspected an underlying inflammatory disorder and treated the patient through immunosuppression with oral prednisone and methotrexate.

The patient’s visual acuity improved gradually over four months.

“Rheumatological assessment and immunological markers were supportive of a diagnosis of systemic lupus erythematosus,” the authors observed.

Mr Chi emphasised that it is rare for lupus to first be detected through Purtscher-like retinopathy.

The case highlighted the importance of conducting a general check-up and immunological assessment in patients who are diagnosed with Purtscher-like retinopathy, he concluded.