Acute ocular ischaemia and orbital inflammation associated with systemic lupus erythematosus

We report a patient with systemic lupus erythematosus (SLE) who developed bilateral ocular ischaemic syndrome in association with orbital inflammation leading to devastating visual loss. A 73 year old white woman presented with unilateral acute anterior uveitis and polyarthropathy of the hands, knees, and neck. Over the next 4 years she suffered recurrent anterior uveitis, marginal keratitis, and episcleritis, which were treated with topical steroids. She had bilateral age related cataract and underwent left cataract surgery. Postoperatively, her visual acuities were 6/60 right eye and 6/9 left eye. She was admitted 7 months later with extensive erythematous, scaly plaques on sun exposed areas and a purpuric eruption over the abdomen, buttocks, and …