Seasonal hyperacute panuveitis (SHAPU) is a unique, serious intraocular inflammatory condition that results in rapid loss of vision [1]. It was first reported after an outbreak in 1975 in Pokhara, Nepal but its mystery remains largely unfolded even after 50 years [2]. It is common in young children and unique to Nepal [3]. It has occurred in cycles in odd years from end of monsoon season (August–September) and the peak of winter (December–January) but lately, sporadic cases are seen in even years as well [4,5]. Initially described as a ‘white pupil in red eye’, it is painless and characteristically unilateral, progressing to blindness and disfigurement due to phthisis bulbi [3].The exact etiology and pathophysiology are unknown. However, much attention has been given to contact with moths, particularly Tussock and Gazalina moths, and got some support after moth hair was detected from cornea in some cases [6,7]. Some bacterial and viral isolates have been noted [8]. It is an ocular emergency; exact treatment is still unclear and prognosis remains poor despite treatment. Early treatment with topical, subconjunctival, oral, or intravitreal antibiotics and/or steroids and surgical treatment with early vitrectomy are being performed with varied success [9].SHAPU is a significant health problem in Nepal. Hundreds of children are irreversibly losing their vision due to this condition. The overall psychosocial and economic implications are huge. Public awareness on this condition needs to be increased in areas of high prevalence. Delays in treatment should be reduced. Proper access to specialized eye care should be ensured. Importantly, a lot of questions need to be answered for better understanding of this disease. Extensive research is required focusing on the etiopathogenesis which can guide us for specific treatment and preventive strategies. It needs a holistic approach and global cooperation for a developing country like Nepal. It will be a true blessing for a lot of innocent children to be able to live their life with this beautiful gift of sight.
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SL, AP, PL were involved in designing, literature review writing and approving the final manuscript.
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