**Question:** 30 year old young male came with sudden onset visual loss with no h/o trauma and the fundus details cant be appreciated with no significant systemic history. The other eye has evidence of sheathing of vessels in periphery. A diagnosis of Eale's disease is made. The most common presenting symptom of this disease is

A. sudden onset visual loss
B. ocular pain
C. photophobia
D. uveitis

**Correct Answer:** A. sudden onset visual loss

**Core Concept:** Eales Disease is a chronic inflammatory disorder of the blood vessels, primarily affecting the retinal and choroidal vessels. It is a type of vasculitis and is characterized by recurrent retinal hemorrhages, edema, and neovascularization.

**Why the Correct Answer is Right:** The most common presenting symptom of Eales Disease is sudden onset visual loss due to the involvement of blood vessels in the retina and choroid, leading to retinal hemorrhages, edema, and neovascularization. In this case, the patient presents with sudden onset visual loss, which is the most common symptom of Eales Disease. Other symptoms like ocular pain, photophobia, and uveitis may also be present, but the most common initial symptom is sudden visual loss.

**Why Each Wrong Option is Incorrect:**

A. Ocular pain and photophobia are not the most common initial symptoms of Eales Disease. While these symptoms may be present, sudden onset visual loss is the most common initial symptom.

B. Uveitis is a general term for inflammation of the uvea, which includes the iris, ciliary body, and choroid. While uveitis can be present in Eales Disease, sudden onset visual loss is the most common initial symptom.

C. Photophobia is the discomfort from light, which is a symptom that can be present in Eales Disease but is not the most common initial symptom. Sudden onset visual loss is the most common initial symptom.

**Clinical Pearl:** Eales Disease is a clinical diagnosis involving the posterior segment of the eye, primarily affecting young males between 20-40 years. It is a part of Behcet's disease complex, which includes oral ulcers, genital ulcers, and skin lesions. Early diagnosis and treatment are crucial to prevent vision loss and progression of the disease.