Eales Disease

EALES DISEASE

Q. 1 Eales disease is:
 A Recurrent uveitis
 B Recurrent iridocyclitis
 C Recurrent vitreous hemorrage
 D Recurrent conjunctivitis
Q. 1 Eales disease is:
 A Recurrent uveitis
 B Recurrent iridocyclitis
 C Recurrent vitreous hemorrage
 D Recurrent conjunctivitis
Ans. C

Explanation:

Recurrent vitreous hemorrage


Q. 2 Panretinal photocoagulation is done in:
 A Background retinopathy
 B Proliferative retinopathy
 C Eales disease
 D Central retinal vein thrombosis
Q. 2 Panretinal photocoagulation is done in:
 A Background retinopathy
 B Proliferative retinopathy
 C Eales disease
 D Central retinal vein thrombosis
Ans. C

Explanation:

Eales disease


Q. 3

A 24 year old smoker is diagnosed of having Eales disease. It is characterized by all of the following, EXCEPT:

 A

Recurrent retinal haemorrhage

 B

Recurrent vitreous haemorrhage

 C

Neovascularization

 D

Proliferative retinopathy

Q. 3

A 24 year old smoker is diagnosed of having Eales disease. It is characterized by all of the following, EXCEPT:

 A

Recurrent retinal haemorrhage

 B

Recurrent vitreous haemorrhage

 C

Neovascularization

 D

Proliferative retinopathy

Ans. D

Explanation:

Eales disease:

  • It is characterized by recurrent vitreous hemorrhages from areas of retinal neovascularization.
  • It is seen in young men in poor general health.
  • It is a diagnosis of exclusion. 
Conditions which shows the same clinical features of Eales disease are,
  • Tuberculosis
  • Sarcoidosis
  • Systemic lupus erythematosus
  • Sickle cell disease
  • Diabetes
Photocoagulation of the new vessels can reduce the chance of further vitreous hemorrhage. 
Patients should stop smoking.
 
Ref: Pringle E., Graham E.M. (2011). Chapter 15. Ocular Disorders Associated with Systemic Diseases. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury’s General Ophthalmology, 18e.

Q. 4

A 27-yr male presents with a sudden, painless loss of vision. His ocular and systemic history is unremarkable. The most likely diagnosis is:

 A

Retinal detachment

 B

Eales’ disease

 C

Glaucoma

 D

Cataract

Q. 4

A 27-yr male presents with a sudden, painless loss of vision. His ocular and systemic history is unremarkable. The most likely diagnosis is:

 A

Retinal detachment

 B

Eales’ disease

 C

Glaucoma

 D

Cataract

Ans. B

Explanation:

Eales’ disease:

  • It is an idiopathic inflammation of the peripheral retinal veins. 
  • It is characterized by recurrent vitreous hemorrhage; so also referred to as primary vitreous hemorrhage.
  • It is a bilateral disease, typically affecting young adult males. 
  • The common presenting symptoms are sudden appearance of floaters (black spots) in front of the eye or painless loss of vision due to vitreous hemorrhage.
4 stages of clinical course:
  • Stage of inflammation
  • Stage of ischaemia
  • Stage of retinal neovascularization
  • Stage of sequelae
  • Treatment: steroids, laser photocoagulation, vitreoretinal surgery.
Ref: Comprehensive Ophthalmology by A K Khurana, 4th edition, Page 254.

Q. 5

A patient with tuberculosis presents with complaints of sudden appearence of floaters in front of the eye. A diagnosis of Eales disease is made.

Assertion: It is caused by hypersensitivity reaction to tubercular proteins.

Reason: Oral corticosteroids is the mainstay of treatment.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 5

A patient with tuberculosis presents with complaints of sudden appearence of floaters in front of the eye. A diagnosis of Eales disease is made.

Assertion: It is caused by hypersensitivity reaction to tubercular proteins.

Reason: Oral corticosteroids is the mainstay of treatment.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. B

Explanation:

Eales disease is an idiopathic inflammation of the peripheral retinal vein. It is caused due to hypersensitivity reaction to tubercular proteins. Oral corticosteroids for extended periods is the mainstay of treatment during active inflammation. In selected cases, a course of antitubercular therapy is indicated.

 
Ref: Comprehensive Ophthalmology By A K Khurana, 4th Edition, Page 254

Q. 6

Retinal detachment seen in:

 A

Myopia

 B

Hypermetropia

 C

Eale’s disease

 D

a and c

Q. 6

Retinal detachment seen in:

 A

Myopia

 B

Hypermetropia

 C

Eale’s disease

 D

a and c

Ans. D

Explanation:

A i.e. Myopia; C i.e. Eale’s disease


Q. 7

In a young patient presenting with recurrent vitreous hemorrhage, diagnosis is:

 A

Eale’s disease

 B

CRVO

 C

Proliferative retinopathy

 D

Coat’s disease

Q. 7

In a young patient presenting with recurrent vitreous hemorrhage, diagnosis is:

 A

Eale’s disease

 B

CRVO

 C

Proliferative retinopathy

 D

Coat’s disease

Ans. A

Explanation:

A i.e. Eale’s disease

Eale’s disease presents with recurrent vitreous haemorrhages in young males Q


Q. 8

A 25 year old male presents withpainless sudden loss of vision, ocular and systemic examination is not contributory.

What is probable diagnosis:

 A

Retinal detachment

 B

Eale’s disease

 C

Glaucoma

 D

Cataract

Q. 8

A 25 year old male presents withpainless sudden loss of vision, ocular and systemic examination is not contributory.

What is probable diagnosis:

 A

Retinal detachment

 B

Eale’s disease

 C

Glaucoma

 D

Cataract

Ans. B

Explanation:

B i.e. Eale’s disease

Glucoma presents with painful sudden (acute congestive / angle closure glucoma) or gradual (chronic simple glucoma) loss of vision. And cataract presents with gradual painless loss of vision.

Retinal detachment and Eale’s disease both can present with sudden painless loss of vision. Eale’s disease is a bilateral disease usually seen in healthy young adults (20-30 years) and presents with recurrent vitreous haemorrhage causing sudden appearance of floatersQ. Opthalmic signs include thickening, tortuosity, congestion and perivascular sheathing of peripheral retinal veins with retinal & vitreous haemorrhage. Whereas RD usually occurs in patients with previous ocular or systemic disease and presents with more prominent ocular signs like low IOP, detached retina, retinal breaks, shifting of fluid, tobacco dust or Shaffer sign (pigmented anterior vitreous) and RAPD (Marcus Gunn pupil) etc.


Q. 9

Eales disease is:

 A

Recurrent optic neuritis

 B

Recurrent pappilloedema

 C

Recurrent periphelbitis retinae

 D

None

Q. 9

Eales disease is:

 A

Recurrent optic neuritis

 B

Recurrent pappilloedema

 C

Recurrent periphelbitis retinae

 D

None

Ans. C

Explanation:

Ans. Recurrent periphelbitis retinae


Q. 10

Eale’s disease is:

 A

Retinal hemorrhage

 B

Vitreous hemorrhage

 C

Conjunctival hemorrhage

 D

Choroidal hemorrhage

Q. 10

Eale’s disease is:

 A

Retinal hemorrhage

 B

Vitreous hemorrhage

 C

Conjunctival hemorrhage

 D

Choroidal hemorrhage

Ans. B

Explanation:

Ans. Vitreous hemorrhage


Q. 11

A 25-year-old male presents with painless sudden loss of vision. Ocular and systemic examination is not contributory. What is probable diagnosis.

 A

Retinal detachment

 B

Eale’s disease

 C

Glaucoma

 D

Cataract

Q. 11

A 25-year-old male presents with painless sudden loss of vision. Ocular and systemic examination is not contributory. What is probable diagnosis.

 A

Retinal detachment

 B

Eale’s disease

 C

Glaucoma

 D

Cataract

Ans. B

Explanation:

Ans. Eale’s disease


Q. 12

Eales’ disease is best treated with:

 A

Antitubercular drugs

 B

Steroids

 C

Antibiotic drops

 D

Antibiotics systemically

Q. 12

Eales’ disease is best treated with:

 A

Antitubercular drugs

 B

Steroids

 C

Antibiotic drops

 D

Antibiotics systemically

Ans. B

Explanation:

Ans. Steroids


Q. 13

Retinal detachment is preceeded by:

 A

Floaters and flashes

 B

Eales’ disease

 C

Trauma

 D

All of the above

Q. 13

Retinal detachment is preceeded by:

 A

Floaters and flashes

 B

Eales’ disease

 C

Trauma

 D

All of the above

Ans. D

Explanation:

Ans. All of the above


Q. 14

In a young patient presenting with recurrent vitreous haemorrhage diagnosis is:

 A

Eales’ disease

 B

Proliferative retinopathy

 C

Proliferative retinopathy

 D

Coat’s disease

Q. 14

In a young patient presenting with recurrent vitreous haemorrhage diagnosis is:

 A

Eales’ disease

 B

Proliferative retinopathy

 C

Proliferative retinopathy

 D

Coat’s disease

Ans. A

Explanation:

Ans. Eales’ disease


Q. 15

Argon laser is used in all except:

 A

Retinal detachment

 B

Retinitis pigmentosa

 C

Retinal vein occlusion

 D

Eales’ disease

Q. 15

Argon laser is used in all except:

 A

Retinal detachment

 B

Retinitis pigmentosa

 C

Retinal vein occlusion

 D

Eales’ disease

Ans. B

Explanation:

Ans. Retinitis pigmentosa


Q. 16

Recurrent vitreous hemorrhage in an otherwise healthy young male is caused by:          

March 2012

 A

Trauma

 B

Retinal vein obstruction

 C

Eale’s disease

 D

Sickle cell retinopathy

Q. 16

Recurrent vitreous hemorrhage in an otherwise healthy young male is caused by:          

March 2012

 A

Trauma

 B

Retinal vein obstruction

 C

Eale’s disease

 D

Sickle cell retinopathy

Ans. C

Explanation:

Ans: C i.e. Eale’s disease

Vitreous hemorrhage

  • Vitreous hemorrhage in the young commonly follows contusion or a perforating injury
  • Venous obstruction is prone to occur when the patient is hypertensive or atherosclerotic. About 3 months after the occlusion, capillary microaneurysms and fibrovascular proliferation may occur & vitreous hemorrhage may arise from the delicate new vessels
  • Eale’s disease is an idiopathic, inflammatory peripheral retinal vasculopathy which presents with recurrent vitreous haemorrhages in young males.
  • Sickle cell C disease has its clinical manifestations predominantly in the eye

Q. 17

Both soft and hard exudates are seen in

 A

Hypertension

 B

DM

 C

Eale’s disease

 D

All of the above

Q. 17

Both soft and hard exudates are seen in

 A

Hypertension

 B

DM

 C

Eale’s disease

 D

All of the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., All of the above

  • All types of severe hypertension (hypertensive retinopathy) including renal disease, Toxemia of pregnancy.
  • Diabetic retinopathy
  • Collagen vascular disorders :- SLE, PAN, systemic sclerosis, scleroderma, wegener granulomatosis.
  • Infections :- AIDS, septic retinitis (including SABE), rarely CMV retinitis in AIDS.
  • Microembolization :- IV drug abuse, Post cardiac surgery, Fat embolism or Purtscher retinopathy.
  • Other :- Eale’s disease, Adults anemia (Hb < 6.6-8.0 g/dl), Pseudoxanthoma elasticum, Neoplasia (Leukemia, Hodgkin's disease), Sickle cell retinopathy, radiation retinopathy.
  • Causes of Hard exudates
  • Sever hypertension (Hypertensive retinopathy), especially with renal disease
  • Diabetic retinopathy, especially with renal disease
  • Infections :- Measles, influenza, meningitis, erysipelas, psittacosis, parasitic infection, coccidioidomycosis, condidiosis, TB, syphilis.
  • Collagen vascular diseases :- Dermatomyositis, SLE, PAN, Bechet’s syndrome, Systemic sclerosis, Rheumatic polyarthritis.
  • Hematological :- Pernicious anemia, other severe adult anemia (Hb < 8 g/dl), leukemia, multiple myeloma. o Eye diseases :- Disciform macular degeneration, Coats disease, Eales disease.
  • Other :- cerebral trauma, after strangulation, fat embolism, lead poisoning, sarcoidosis, old central retinal vein thrombosis, Retinal artery macroaneurysm, Choroidal neovascularization, Hypercholesterolemia.

 

 

  • Two important facts require specific mention here :-
  • Severe hypertension of any type (including toxemia of pregnancy) can cause soft exudate. On the other hand severe hypertension associated with renal disease causes hard exudate (not toxemia of pregnancy).
  • Diabetic retinopathy, hypertensive retinopathy, Eale’s disease and collagen vascular disease can cause both soft and hard exudates.

Q. 18

Parachute lesions are seen in ‑

 A

Eale’s disease

 B

Diabetes

 C

Sickle cell anemia

 D

All of the above

Q. 18

Parachute lesions are seen in ‑

 A

Eale’s disease

 B

Diabetes

 C

Sickle cell anemia

 D

All of the above

Ans. D

Explanation:

Ans. is d  i.e., All of the above 



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