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Journal of AAPOS 2017-Nov

Amblyopia due to intermediate uveitis as the presenting symptom of Crohn's disease in a 6-year-old boy.

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Chrysanthos Symeonidis
Artemis Matsou
Despoina Tzetzi
Maria Dermenoudi
Periklis Brazitikos
Asimina Mataftsi

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A 6-year-old boy presented with unexplained unilateral low visual acuity. Best-corrected visual acuity was counting fingers in the right eye and 20/20 in the left eye. Fundus examination of the right eye revealed intermediate uveitis, with moderate vitritis, snowballs, and snowbanking. Infectious and noninfectious conditions known to be associated with intermediate uveitis were excluded. Vitreous inflammation gradually resolved with oral steroids, and amblyopia treatment with left eye patching was advised. Several months later the boy suffered acute monoarthritis and episodes of mucopurulent diarrhea; a terminal ileum biopsy was consistent with Crohn's disease. This case of Crohn's disease and uveitis is unusual in that ocular inflammation preceded intestinal involvement, with the atypical feature of chronic intermediate uveitis.

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