A patient with no known past medical or ocular history presents with 1 week of redness and sudden, painless vision loss in the right eye. In the right eye, exam was notable for visual acuity CF, a relative afferent pupillary defect, 3+ anterior chamber cell, 3+ vitreous cell, and an area of active retinal whitening with overlying vitritis. The left eye was normal. The patient was empirically started on oral clindamycin, bactrim, and valacyclovir as well as topical prednisone and atropine. The patient underwent an anterior chamber paracentesis and injection of foscarnet, gancyclovir, and clindamycin. PCR of the paracentesis fluid was positive for toxoplasmosis and serum toxoplasmosis antibodies were positive. At follow-up two weeks after the procedure, vision in the right eye was 20/250 and exam revealed improving retinal whitening and vitritis.
Presentation Date: 09/28/2023
Issue Date: 10/20/2023