Young Man with Red, Painful Eye

By: | Tags: | Comments: 0 | December 4th, 2018

Case Study: Young Man with Red, Painful Eye

Dr Robyn Troutbeck


  • 18 year old male
  • Red, painful eye for 1 week
  • Increasing floaters
  • VA 6/6

What is the most likely diagnosis?

a) Cotton wool spot
b) Old scar
c) Toxoplasmosis chorioretinitis
d) Acute retinal necrosis

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Answer c.

Toxoplasmosis is ususally a clinical diagnosis. The patient typically presents with a granulomatous inflammation with an area of choioretinitis and overlying vitritis.

Which patients do you treat?

a) All
b) None
c) If the inflammation is next to the disc, macula or vessel
d) If the patient is immunosuppressed
e) If there is significant vitritis

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c, d and e

If the patient has no allergies the first line treatment is usually Bactrim DS and oral and topical steroid,