We appreciate the comments given on our case report(1) and have the following clarifications to offer.

Our patient had typical features of Vogt Koyanagi Harada Syndrome (VKHS) and also fulfills the criteria given by the American Uveitis Society(2). She had distinct neurological findings including CSF pleocytosis, characteristic cutaneous lesions and there was no history of previous ocular trauma or surgery. As regards uveitis, the patient was symptomatic two years ago for two weeks and was treated early during the course of uveitis with an ayurvedic medication (probably a steroid containing preparation). Therefore this had possibly left no sequelae two years later. This fact of good recovery with early use of immunosuppresants has been well emphasized by other authors also(3,4) though sequeale are well known in some.

Our patient did have an evidence of abdominal tuberculosis later in the course of illness, but her earlier neurological features such as tinnitus, deafness and a component of meningoencephalitis along with poliosis, alopecia were a definite pointer to VKHS and not Alezzandrini's syndrome (a close differential) or tuberculosis. Even the CSF tubercular antigen of this patient was negative. Thus our case was of VKHS and in the recovery had developed abdominal tuberculosis.

Sushma Malik,
Surekha Joshi,
Department of Pediatrics,
T.N. Medical College and
 B.Y.L. Nair Hospital,
Mumbai 400 008, India.

1. Malik S, Gupta AK, Joshi SM, Purohit SN, Khopkar US. Vogt Koyangi Harada Syndrome. Indian Pediatr 1997; 34: 1124-1126.

2. Masi RJ. Syndromes of possible infectious origin. In: Infections of the Eye, 1st edn. Eds. Tabbara KF, Hyndiuk RA. Boston, Little Brown and Co, 1986; pp 587-600.

3. Rubsamen PE, Gass DM. Vogt Koyangi Harada Syndrome - Clinical course, therapy and long term visual outcome. Arch Opthalmol1991; 109: 682-687.

4. Mosher DB, Fitzpatrick TB, Ortonne JP, Hori Y. Disorders of pigmentation. In: Dermatology in General Medicine, 4th edn. Eds. Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg 1M, Austen KF. New York, McGraw-Hill Booh Co., 1993; pp 933-955.