DR. ABHIDNYA SURVE

PROF.PRADEEP VENKATESH, DR. ROHAN CHAWLA

Abstract

Fifty year old male had been previously diagnosed with optic neuritis and managed with intravenous and oral steroids in last 6 months. He presented with diminution of vision in both eyes and was already on oral steroids. Ocular examination revealed both eyes disc edema. On evaluation, he was found to be HIV and HBsAb positive while VDRL was negative. He was started on anti-retrovirals and HBsAg treatment with tapering of steroids. After 10 days, patient had further diminution of vision with development of anterior uveitis both eyes and retinitis patch in one eye. On detailed investigation and clinical examination, TPHA and VDRL in dilution was positive and patient was successfully managed with syphilitic treatment. This case highlights the diagnostic dilemma one faces while managing a triple disease case and the salient features to note for early diagnosis and management.