More Than Meets the Eye: A Rare Encounter of Fuchs' Uveitis Syndrome in Multiple Sclerosis.

Abstract

Background:
Fuchs' Uveitis Syndrome (FUS) is a chronic form of anterior uveitis characterized by low-grade intraocular inflammation, stellate keratic precipitates, and iris heterochromia. The disease often follows an indolent course and may remain asymptomatic until detected during routine ophthalmic examination. Although most cases are idiopathic, associations with systemic immune-mediated disorders have been increasingly recognized.
Case Presentation:
We report the case of a 47-year-old male with secondary progressive multiple sclerosis (SPMS), type 2 diabetes mellitus, Graves' disease, vitiligo, and dyslipidemia who was referred for routine ophthalmologic evaluation. The patient reported no ocular complaints. Slit-lamp examination showed presence of diffuse stellate keratic precipitates and iris heterochromia in the right eye with a deep
anterior chamber. Intraocular pressure was found to be 10 mmHg bilaterally. Fundoscopic examination demonstrated normal retinal and optic disc morphology. Optical coherence tomography of the macula was normal in both eyes. Based on characteristic slit-lamp findings, a diagnosis of unilateral Fuchs' Uveitis Syndrome was made. Since the patient was asymptomatic conservative management with periodic follow-up was recommended.
Conclusion:
This case underscores the subtle presentation of Fuchs' Uveitis Syndrome and emphasizes the importance of routine ophthalmologic evaluation in patients with systemic autoimmune or neuroinflammatory conditions including multiple sclerosis. Early recognition of this association may facilitate timely diagnosis and monitoring that will help in preventing long-term ocular complications.