Bullous retinal detachment associated with renal failure: case report

A case of bilateral bullous retinal detachment in a patient with long-standing disseminated lupus erythematosus is presented. Although several authors have reported the presence of bullous retinal detachment in association with chronic renal disease, in no other case have the ocular findings preceded the onset of frank renal failure. The etiology of nonrhegmatogenous detachment and uveal effusion in association with chronic renal disease was discussed and the possible contributory role of hypertension, electrolyte imbalance, and renal glomerular malfunction was investigated. The additional finding of late onset bilateral keratoconus is, in all probability, unrelated to the patient's retinal findings, though it is a major factor in her present visual morbidity. The purpose of this paper is twofold. First-ly, to alert the ophthalmologist to the possible development of bullous retinal detachment in patients with chronic renal disease, and secondly, to alert the internist to the possibility of impending renal failure in patients with such bilateral nonrhegmatogenous detachments.