Eales Disease

Excerpt

Eales disease classically presents with repeated vitreous hemorrhage in young adults. It is most commonly found in the Indian subcontinent. It commonly affects the peripheral fundus and is characterized by retinal vasculitis. In the year 1880, it was Sir Henry Eales, who first described the Eales disease in a cluster of young males, as idiopathic obliterative vasculopathy, which presented with recurrent vitreous hemorrhage in association with headache, constipation, and epistaxis.

In such cases of retinal periphlebitis, systemic causes, including tuberculosis and sarcoidosis, should be ruled out. The clinical spectrum of Eales disease is divided into several stages, and the management is determined by the stage of the disease. Management includes intraocular and periocular steroids and oral corticosteroids, which are needed to control the activity of bilateral retinal vasculitis. Laser photocoagulation is needed in stages of retinal ischemia and neovascularization. Cases in which vitreous hemorrhage persists and does not resolve in several months, with or without retinal detachment need vitrectomy, the results of which are quite satisfactory. The role of antitubercular therapy in such cases without any other systemic focus is debatable and needs further evaluation.