To report a case of presumed ocular leishmaniasis in an Afghan woman

A 40-year-old woman presented to us with bilateral decreased visual acuity . Best corrected visual acuity (BCVA) were 3/10 in both eyes. Ocular examination revealed bilateral granulomatous pan- uveitis , hypotonia , multiple chalazion- like lesions located on the upper and lower eyelids.

Review of the patient’s history disclosed renal transplantation under systemic immunosuppressive medication , cutaneous lesions on the hands. All of the laboratory tests were inconclusive . Polymerase chain reaction (PCR) of vitreous sample and vitreous biopsy were negative. Excisional biopsy of the skin and chalazion –like lesions showed leishman body . Systemic evaluation was negative for visceral leishmaniasis (Kala-Azar). With diagnosis of presumed ocular leishmaniasis,the patient was treated with systemic Amphotericin B due to unavailability of glucantime . Bilateral ocular inflammation and eyelid lesions improved significantly .Bilateral Cataract surgery and pars plana deep vitrectomy were performed for cataract and permanent hypotonia .Last BCVA was 3/10 and 1/10 .

Ocular leishmaniasis should be considered in the differential diagnosis of chalazion –like ulcerative lesions associated with bilateral granulomatous panuveitis, especially in endemic areas.