Background: Fuchs uveitis is characterized by chromic iridocyclitis, iris heterochromia or iris atrophy, and cataracts. Bilateral involvement of Fuchs uveitis is around 10% outside Japan. In Japan, however, reports of bilateral Fuchs uveitis are extremely rare. We describe five cases of bilateral Fuchs uveitis referred to the Japan Community Health Care Organization (JHCO) Tokyo Shinjuku Medical Center.
Cases: Cases 1 to 3 chronic iridocyclitis without iris synechia, but with iris atrophy, cataract formation and vitreous opacity in both eyes. Diagnosis of bilateral Fuchs uveitis was made because there were no signs of other types of uveitis. Case4 had been diagnosed as bilateral iridocyclitis. On the first visit the patient presented cataract and iris atrophy in the left eye. After a follow up without steroid eye drops, cataract and iris atrophy appeared in the right eye as well. Case5 had already undergone bilateral cataract surgery and had been treated continuously with steroid eye drops for persistent bilateral unknown vitreous haze. Finally, a diagnosis of Fuchs uveitis was made because of the appearance of keratic precipitates after discontinuation of the steroid eye drops, positive Amsler's sign and positive anti-rubella antibodies in the aqueous in both eyes.
Conclusion: Bilateral Fuchs uveitis should be considered as part of the differential diagnosis of bilateral uveitis.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121: 535-545, 2017.