An 80-year-old white man was referred to the uveitis clinic at the Vanderbilt Eye Institute, Nashville, TN, by an outside retina specialist for irritation, soreness, and ï¬oaters of the left eye for 3 months. During this time, he had “ï¬ared twice” while attempting to taper off topical diï¬uprednate drops for presumed intermediate uveitis.
Secondary ocular hypertension of the treated eye was being managed with twice-daily topical dorzolamide. Ophthalmic history was negative for surgeries or conditions except cataracts.
He reported multiple tick bites about 8 to 10 years ago, and denied history of cold sores. Review of systems was positive for left-sided headache and increase in left-sided ear drainage, but otherwise negative.
Diagnosed with Lyme disease, this patient had been treated with tetracycline for 1 month prior to referral. Past medical history was otherwise signiï¬cant for coronary artery disease status post-stenting 2 months prior, hypertension, prostate cancer status post-radical prostatectomy 6 years previously, a vertebral fusion at levels L3 – L4, and a heel spur excision. There were no known drug allergies.
Rheumatologic conditions, such as systemic lupus erythematous, rheumatoid arthritis, or osteoarthritis, were denied.
He was a retired computer programmer born and permanently residing in western Tennessee, though he did travel on occasion to Central America, Europe, and Washington State, but not the Northeastern states.