What are the other Names for this Condition? (Also known as/Synonyms)

• MEWDS (Multiple Evanescent White Dot Syndrome)

What is Multiple Evanescent White Dot Syndrome? (Definition/Background Information)

• Multiple Evanescent White Dot Syndrome (MEWDS) is a rare disorder affecting the retina, typically of one eye. It belongs to a group of disorders known as white dot syndromes
• The condition results in signs and symptoms that include vision abnormalities, blurred vision, and blind spots causing vision loss. Multiple Evanescent White Dot Syndrome is generally observed in young, middle-aged, and slightly older adults
• The cause and risk factors for Multiple Evanescent White Dot Syndrome is not well-known. No underlying condition or disorder is known to be associated with MEWDS
• A healthcare provider can use various eye exams, blood tests, and imaging studies to diagnose Multiple Evanescent White Dot Syndrome. Upon diagnosis, treatment options, such as a ‘wait and watch’ approach or steroids, can be used to treat the condition
• The prognosis for Multiple Evanescent White Dot Syndrome depends on each individual's signs and symptoms, but is generally excellent. A majority of cases are known to get better on their own spontaneously (it is a self-limiting disorder)

Who gets Multiple Evanescent White Dot Syndrome? (Age and Sex Distribution)

• Multiple Evanescent White Dot Syndrome can present itself at any age, but is more likely to occur between the ages of 15-60 years
• Both males and females are affected, though nearly 80% of the cases are observed in females (female-male ratio is 4:1)
• Individuals of different racial and ethnic backgrounds can be affected

What are the Risk Factors for Multiple Evanescent White Dot Syndrome? (Predisposing Factors)

• The risk factors for Multiple Evanescent White Dot Syndrome are currently unknown

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Multiple Evanescent White Dot Syndrome? (Etiology)

• Currently, the cause of Multiple Evanescent White Dot Syndrome is not clearly understood or identified
• MEWDS is a type of white dot syndrome; white dot syndromes are a group of eye disorders that involve inflammation of the retina and choroid

What are the Signs and Symptoms of Multiple Evanescent White Dot Syndrome?

The signs and symptoms of Multiple Evanescent White Dot Syndrome may vary between individuals and may include:

• Vision abnormalities such as reduced or blurred vision
• Light-sensitivity or photophobia
• Presence of blind spots, or scotoma, causing partial vision loss
• Flashes of light in the eye, or photopsia
• Small specks, called floaters, that may be seen moving through one's field of vision
• The condition is generally unilateral and one only eye is affected
• One-third of the individuals may have flu-like symptoms prior to onset of eye-related signs and symptoms

How is Multiple Evanescent White Dot Syndrome Diagnosed?

A healthcare professional may diagnose Multiple Evanescent White Dot Syndrome using the following tests and procedures:

• Physical examination and analysis of previous medical history
• Eye examination by an eye specialist
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination: Examination of the eye structure using a special instrument called a slit-lamp. In this procedure, the pupils are dilated and the internal eye structure is examined
• Tonometry: Measurement of intraocular pressure or eye fluid pressure, especially to detect conditions such as glaucoma
• Fundus fluorescein angiography (FFA): In this technique, the eye blood vessels are examined using a fluorescein dye
• Fundus autofluorescence (FAF) imaging: It is a diagnostic technique to examine the fundus of the eye using a fluorescent dye
• Indocyanine green (ICG) angiography: It is used to examine the blood vessels of the choroid using a dye, called indocyanine green, particularly to study the choroid
• B-scan ultrasonography: Special ultrasound scan of the eye through a non-invasive diagnostic tool, to assess health of the eye structures
• Electroretinogram (ERG): It is a technique to measure electrical activities in the retinal cells
• Optical coherence tomography (OCT) of eye: Radiological imaging technique to visualize the eye structure
• Blood tests that include:
  • To check for the presence of antibodies in blood
  • Blood culture for infections
  • Complete blood count (CBC) with differential
  • Erythrocyte sedimentation rate (ESR)

If individuals have other signs and symptoms, then the following tests may be performed:

• Chest X-rays
• Neuroimaging studies including MRI scan of brain
• Lumbar puncture: In this procedure, the cerebrospinal fluid is collected and analyzed

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Multiple Evanescent White Dot Syndrome?

Significant complications of Multiple Evanescent White Dot Syndrome are generally not observed. In some cases, the complications may include:

• If left undiagnosed and/or untreated, the condition can lead to vision loss
• Kidney damage, high blood sugar, and high blood pressure due to steroid treatment
• Recurrent Multiple Evanescent White Dot Syndrome: The condition may recur if the underlying cause is not identified and treated appropriately. Recurrences are observed in about 1 in 10 cases. With each recurrence, the signs and symptoms may get more severe

How is Multiple Evanescent White Dot Syndrome Treated?

Currently, standard treatment protocols are not well-established for Multiple Evanescent White Dot Syndrome. However, some cases are known to resolve spontaneously and the condition can be self-limiting.

The treatment may include the following measures:

• The healthcare provider may choose to monitor the condition and follow a ‘wait and watch’ approach
• Administration of oral medications (including pain medications)
• Steroids may be administered to control the inflammation
• Dark glasses may be prescribed for light-sensitivity
• If the underlying cause is unknown, then decreasing inflammation is the main step towards treating MEWDS

It is important to note that steroids may not be used in all cases, since it can worsen the condition. A healthcare provider will provide the best treatment options based upon each individual’s specific circumstances.

How can Multiple Evanescent White Dot Syndrome be Prevented?

It may be difficult to prevent Multiple Evanescent White Dot Syndrome, but the risk for the condition may be lowered through the following measures:

• Educating the individual and family members about the underlying cause condition (if possible)
• Treating any underlying infections and immunologic conditions (especially eye-related), as early as possible
• Maintaining long-term follow-up checkups to watch out for any recurrences

What is the Prognosis of Multiple Evanescent White Dot Syndrome? (Outcomes/Resolutions)

• The prognosis of Multiple Evanescent White Dot Syndrome is generally excellent, as the condition is self-resolving in many cases. The signs and symptoms get better in 3-10 weeks
• However, the prognosis also depends upon the severity of the signs and symptoms. MEWDS is known to recur, and in some cases, individuals may take a longer time to fully recover from the condition

Additional and Relevant Useful Information for Multiple Evanescent White Dot Syndrome:

Please visit our Eye & Vision Health Center for more physician-approved health information:

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