Dubai neurologist saves eyesight of patient with timely diagnosis and treatment.

Dubai: A 36-year-old Indian expatriate, who nearly lost his eyesight to a rare condition that affects one in a million each year, had his vision restored — thanks to the quick thinking by a Dubai neurologist. Timely diagnosis of Tolosa Hunt Syndrome (THS) helped the neurologist at Medeor Hospital initiate action that cured the patient of the ailment in three days.

Loss of vision in one eye

In early April 2022, Faiz Muhammad Yusuf, an expatriate working in a company in Dubai, was excited and gearing up for his long-awaited vacation. However, just a few days before his flight, Yusuf, hailing from Chennai, India, experienced a severe headache and fever. This was followed by loss of vision in his left eye.

In addition, Yusuf also developed double vision, drooping of the left eyelid and multiple cranial nerve palsy. Due to extreme pain, he was unable to eat or drink. Yusuf’s friends rushed him to the Emergency Section of Medeor Hospital, Dubai, on April 2. A consultant ophthalmologist, who examined him, realised the problem had a neurological root and referred him to Dr Anas Abdul Majeed, consultant neurologist at the hospital. Upon detailed examination of the patient, Dr Majeed stumbled upon a rare diagnosis.

Comprehensive screening confirms diagnosis

Dr Majeed told Gulf News: “After clinical examination of the patient, I prescribed a brain MRI. This imaging showed a well-defined lesion behind his left eye, which opened up possibilities for different diagnosis.” Dr Majeed ordered a lumbar puncture, through which the cerebrospinal fluid of the patient was drawn and examined to rule out grave conditions, including meningitis. “Only after following these diagnostic tests, was I able to diagnose that Yusuf suffered from the rare THS based on the diagnostic criteria and detailed investigations.”

What is Tolosa Hunt Syndrome?

According to the United States-based National Organisation for Rare Disorders, THS is a rare neurological disorder occurring in one in a million persons a year, impacting the ocular neural nerve, characterised by sharp, stabbing pain in usually one eye, severe headache, accompanied by double vision or loss of vision. If diagnosed in time, it is possible to reverse the condition.

Dr Majeed added: “This condition is idiopathic and there are no reasons as to why it occurs. It is not a congenital or genetic disorder and once diagnosed can be treated with steroids for complete recovery. It is important that the patient undergoes a proper treatment protocol to prevent any chances of a relapse.”

Quick medical intervention is the key

Dr Majeed swiftly started the medications, including steroids. “Yusuf responded well to medications and started showing signs of recovery just two days after being admitted to ICU [Intensive Care Unit]. We administered him IV steroids for three days and he showed significant improvement,” Dr Majeed said.

Vision restored

After spending around four days in hospital, Yusuf was discharged and within two days after that, he flew back to India to spend his vacation with his family.

Yusuf, who was grateful to Dr Majeed, thanked him for the timely intervention and for saving his eyesight. “I am grateful to God. I am also thankful to Dr Majeed and his team. My pain was unbearable. I could not eat or drink anything. I was unable to see anything. By the time, I reached the hospital, the pain had increased and my health had deteriorated considerably. I could have lost my eyesight had the doctor not done a correct diagnosis and treated me. My family and I will remember him in our prayers for our lifetime.”

Challenging case

Dr Majeed added: “Yusuf was lucky that his condition was correctly diagnosed as THS is a rare and complicated disease. Timely treatment through vast therapeutic armamentarium and teamwork was crucial to the patient’s timely recovery. He is advised regular follow-up after recovery.”

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