A 30year old lady from Nanded presented with sudden onset redness and blurring of vision in her left eye for 1week. On examination, her right eye vision was 6/6 which is normal and left eye vision was 6/60. Her left eye showed a severe reaction inside the eye (Figure 1a and 1b.)

Leptosiral-Uveitis

Figure 1a. Right eye of the patient showing normal retina

Leptospiral-Uveitis

Figure 1b. Left eye of the patient showing severe immune reaction inside the eye (vitritis)

Based on history and clinical examination, the patient was advised blood tests. Her liver function test was abnormal and her tests came out to be positive for Leptospirosis. She was started on oral medication and she recovered complete vision after 2 weeks. (Figure 2a and 2b).

Leptospiral-Uveitis

Figure 2a. Right eye of the patient after 1 month.

Leptospiral-Uveitis

Figure 2b. Left eye after 1 month

What is Leptospirosis?

Leptospirosis is caused by a bacteria and is a disease of animals, like dogs and rats. Humans get infected when they are exposed to rat urine due to occupation, like working barefoot in rice fields, or recreational activities like water sports or consuming drinks contaminated with rat urine. In humans Leptospirosis causes fever, jaundice, vomiting. It has a high mortality rate. In the eye it causes intraocular inflammation or uveitis.

What are the symptoms of leptospiral uveitis?

Redness of the affected eye and blurred vision with floaters.

How is Leptospiral uveitis diagnosed?

A uveitis specialist will do a detailed eye examination with dilatation of the pupil. He/she may advise certain eye scans and blood tests for the confirmation of the disease.

How is Leptospiral uveitis treated?

The treatment is with oral antibiotics with or without steroids. In case you develop cataract due to uveitis, you may need to undergo cataract surgery as well.

How to prevent Leptospirosis?

Patients must only drink water from a reliable source or drink only boiled or filtered water. Farmers should not work barefoot in paddy fields. All precautions and personal protection must be used while going for water sports. Maintaining hygiene and cleanliness at home is also important. People working in godowns must take necessary precautions as these places are often infested with rats. While drinking directly from cans and tetra pak containers one must clean the surface as these may often be contaminated.

 

Dr Abhilasha Baharani

Dr Abhilasha Baharani

DNB FRCS (Glasg) FICO Uvea & Cataract Specialist at Neoretina
Dr. Abhilasha Baharani is a specialist in Uveitis and Ocular inflammation. Her areas of expertise are Uveitis & Ocular Immunology- management of ocular tuberculosis, immunosuppressive therapy for non-infectious uveitis & scleritis, phacoemulsification in small pupil, complicated cataracts and ocular manifestations of systemic diseases. She studied MBBS at Kasturba Medical College Mangalore and DNB at Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Tirunelveli. She did her fellowship in Uveitis & Ocular Inflammation at Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Madurai and a second fellowship in Ocular Inflammatory Disease in Vitreoretinal Disorders at the Royal Victoria Eye and Ear Hospital, Dublin, Ireland where she became well-versed with newer immunosuppressive agents and use of biologic blockers. She is a member of the International Ocular Inflammation Society and is an active member of the state and national academic societies. She has received the Carl Herbort Award for her research paper at the Uveitis Society of India Annual Meeting in 2012 and Award of Distinction and Award of Merit for her research papers at the International Ophthalmology Congress- Innovations and Challenges in Glaucoma & Uveitis, Singapore, 2014.
Dr Abhilasha Baharani