Presentation is usually with floating spots in the field of vision. Usually, both eyes are affected. The patient is typically a young adult. Both sexes are equally affected.
Evidence of anterior uveitis is minimal - a few cells may occasionally be evident in the anterior chamber. Anterior and posterior synechiae are rare. Posterior subcapsular cataracts are frequent.
Indirect ophthalmoscope reveals 'snowballs' or 'cotton wool balls' - small, fluffy, vitreous inflammatory foci at the extreme periphery, often overlying the pars plana.
The disease usually remains stationary or gradually improves over a 5-10 year period. Some patients develop macular oedema and scarring, and in severe cases, retinal detachment may occur. Glaucoma is a rare complication.
The cause is unknown. Treatment is with oral corticosteroids supplemented if necessary, with sub-Tenon or retrobulbar injections. This treatment increases the risk of cataracts but fortunately, these patients do well following cataract surgery.
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