DR. ANSU ANN JOHN

Abstract

A 56 year old alcoholic male patient, a known case of decompensated liver disease and nephropathy presented with complaints of decreased vision in both eyes for 1 year. Pupillary reaction was normal with early lens changes. Fundus examination showed temporal pallor, CD ratio of 0.6, venous dilation, arteriolar attenuation, multiple Roth spots, cotton wool spots and absent foveal reflex. Extensive superficial and deep hemorrhages both in the peripapillary area and along the vascular arcades were present. In view of the retinopathy he was referred to Medicine department to rule out diabetes mellitus, bleeding diathesis or infective foci all of which came back as negative. Hemoglobin was found to be 6.5 g/dl with decreased ferritin levels. This case is presented for its rarity and to highlight that ocular features in systemic disease can be severe and present with a dilemma regarding etiology. Early ophthalmic evaluation of can help with both diagnosis and prognosis.