Bilateral Acute Myopia: Do Not Overlook Bilateral Uveal Effusion

To describe an atypical case of bilateral uveal effusion, presumably triggered by amoxicillin, in a 10-year-old child with pneumonia.

A comprehensive ophthalmological evaluation and imaging studies, including anterior segment and macular optical coherence tomography, ultrasound biomicroscopy, and B-mode ultrasonography, were performed to assess anatomical changes and confirm the diagnosis.

A 10-year-old boy presented with an acute, painless loss of visual acuity in both eyes, primarily affecting distance vision. He had a recent history of pneumonia, which had been treated with amoxicillin. Ophthalmic examination revealed bilateral acute myopia, significant refractive error, and shallow anterior chambers in both eyes. Ultrasound biomicroscopy and anterior segment optical coherence tomography revealed fluid in the supraciliary space and anterior rotation of the ciliary processes, suggestive of uveal effusion. Based on these findings, uveal effusion was suspected, prompting the discontinuation of amoxicillin. The patient was treated with topical dexamethasone, cyclopentolate, and oral azithromycin. After stopping amoxicillin and initiating treatment, the patient's myopia resolved, anterior chamber depth normalized, and the uveal effusion was resolved within three days. The patient remained asymptomatic during a 6-month follow-up period.

This case suggests a possible link between amoxicillin use and bilateral uveal effusion, a relationship not previously reported. Healthcare professionals should consider uveal effusion in the differential diagnosis of patients presenting with bilateral acute myopia, particularly when associated with recent medication use. Further research is needed to explore the potential role of amoxicillin in inducing uveal effusion.