Dr. HEMA V.K

Dr.VIRNA SHAH

Abstract

A 25 years old female presented with sudden loss of vision in right eye for 3 weeks & pain on eye movements. She had past history of breathlessness & menorrhagia for 6 years .She was treated elsewhere as autoimmunehemolytic anemia ,undergone blood transfusion & was on azathioprine which she had stopped herself.She had relative afferent pupillary defect & disc edema in right eye & pale disc in left eye.Our clinical diagnosis was right eye retrobulbar neuritis & left eye optic atrophy .Blood routine showed anemia with thrombocytopenia. Our physician found out splenomegaly ,worked up & diagnosed as a rare entity Evan’s syndrome . MRI Showed acute inflammatory change in right optic nerve.She was treated with IV methylprednisolone. Evan’s syndrome is rare & challenging autoimmune condition .Association with retrobulbar neuritis is rare.Evan’s syndrome can itself be the first manifestation of other rheumatological and immunological diseases . So earliest diagnosis & treatment is mandatory.