Bilateral Exudative Retinal Detachment in a Young Patient with Chronic Renal Failure

Chronic renal failure (CRF) is a multi-systemic disease affecting different organ systems of the body. Ocular manifestations of chronic renal disease include squint, subconjunctival hemorrhage, vitreous hemorrhage, neovascular glaucoma, cataracts and retinal detachment. These result in visual impairment or blindness. In this article, a case of bilateral exudative retinal detachment (ERD) in a pediatric patient with CRF and hypertension is presented.

The patient is a 16-year-old girl with CRF, grade 3 hypertension, and bilateral ERD. Detailed ophthalmic evaluation including visual acuity, anterior and posterior segments evaluation with +78 DS super field lens and digital slit lamp, intraocular pressure (IOP) measurement using a non-contact tonometer. B-mode ocular and renal ultrasounds scan were done.

With the management of systemic hypertension, and hemodialysis, a slight improvement of vision was noted but this was not sustained as renal replacement therapy was not continued due to financial constraints.

Ocular disturbances may be the pointer to renal compromise. There is a need for thorough systemic review in patients with ocular symptoms and ocular evaluation in all patients with CRF and hypertension.