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34-year-old man has congenital toxoplasmosis in both eyes. He had a reactivation with uveitis which I treated 6 years ago. That was his first episode and since then he had been doing fine. Then about four weeks ago he developed another episode in the right eye where his vision is foggy and he has floaters and his vision is hazy in the right eye. VISUAL ACUITY: Vision OD is 20/40, OS 20/30. IOP: OD 17, OS 19. The lenses are clear. EXTENDED OPHTHALMOSCOPY: OD: CD ratio is 0.3. There is a posterior vitreous separation and 2+ vitreous cells. There is a chorioretinal scar superotemporal to the macula, the inferior edge of which has a little bit of whitening from activity of the toxoplasmosis. There is also periphlebitis. It is almost exactly as it was in 2005. OS: CD ratio is 0.5. There is a dry macular scar superior to the macula. IMPRESSION: 1. CONGENITAL TOXOPLASMOSIS IN BOTH EYES 2. REACTIVATION IN THE RIGHT EYE DISCUSSION: I explained to the patient the right eye is active, but it is nonthreatening. The lesion is nowhere near his fovea or his macula or his optic nerve. I suggested we do the six week Bactrim course again. I asked him to return for check in four weeks, sooner should he notice a problem.

toxood_boro01.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye259 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro02.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye213 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro03.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye146 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro04.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye232 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro05.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye204 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro06.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye133 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro07.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye150 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro08.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye107 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro09.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye88 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro10.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye98 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxood_boro11.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye159 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxoos_boro01.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye143 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxoos_boro02.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye192 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
toxoos_boro03.jpg
Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye210 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/3000000
(0 votes)
   
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34-year-old man has congenital toxoplasmosis in both eyes. He had a reactivation with uveitis which I treated 6 years ago. That was his first episode and since then he had been doing fine. Then about four weeks ago he developed another episode in the right eye where his vision is foggy and he has floaters and his vision is hazy in the right eye. VISUAL ACUITY: Vision OD is 20/40, OS 20/30. IOP: OD 17, OS 19. The lenses are clear. EXTENDED OPHTHALMOSCOPY: OD: CD ratio is 0.3. There is a posterior vitreous separation and 2+ vitreous cells. There is a chorioretinal scar superotemporal to the macula, the inferior edge of which has a little bit of whitening from activity of the toxoplasmosis. There is also periphlebitis. It is almost exactly as it was in 2005. OS: CD ratio is 0.5. There is a dry macular scar superior to the macula. IMPRESSION: 1. CONGENITAL TOXOPLASMOSIS IN BOTH EYES 2. REACTIVATION IN THE RIGHT EYE DISCUSSION: I explained to the patient the right eye is active, but it is nonthreatening. The lesion is nowhere near his fovea or his macula or his optic nerve. I suggested we do the six week Bactrim course again. I asked him to return for check in four weeks, sooner should he notice a problem.