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More than meets the eye
  1. Usha B Blessin1,
  2. Andreas Fischer1,
  3. Thomas Schneider2,
  4. Verena Moos2,
  5. Tobias Müller1,
  6. Karsten H Weylandt1,
  7. Uwe Pleyer3
  1. 1Division of Gastroenterology and Hepatology, Department of Medicine, Charité University Medicine—Campus Virchow Hospital, Berlin, Germany
  2. 2Division of Gastroenterology, Rheumatology and Infectiology, Department of Medicine, Charité University Medicine—Campus Benjamin-Franklin, Berlin, Germany
  3. 3Department of Ophthalmology, Charité University Medicine—Campus Virchow Hospital, Berlin, Germany
  1. Correspondence to Dr Karsten H Weylandt,, Department of Medicine, Division of Gastroenterology and Hepatology, Charité University Medicine—Campus Virchow Hospital, Augustenburger Platz 1, Berlin 13353, Germany; karsten.weylandt{at}charite.de

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Clinical presentation

A 74-year-old woman was admitted to the ophthalmology department with progressive vision loss, vitreous clouding and suspected endogenous endophthalmitis. Bilateral eye problems had started several weeks before and grew worse under oral prednisolon therapy. After admission, progressive vitreous haze was diagnosed (figure 1A). A diagnostic vitrectomy was performed for microbiological testing.

Figure 1

Assessment of the left eye before vitrectomy. Preretinal ‘white material’ was visible on ophthalmoscopy within the vitreous cavity (A). Endoscopic view into the second part of the duodenum (B) and the terminal ileum (C), showing ragged erythematous mucosa and lymphangiectasia.

The patient was also presented with watery diarrhoea that had started 6 months ago. Bowel movements were independent of food ingestion and occurred also during the night; furthermore, the patient reported weight loss of 6–7 kg, epigastric pain, latent nausea and deterioration …

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