A 35-year-old otherwise healthy man born in Brazil presented with a 1-week history of a mildly red eye associated with blurry vision and moderate orbital pain in his left eye. He had a history of ocular disease. He denied taking any medication and did not report any systemic symptoms.
His visual acuity was 20/40 in the left eye and 20/20 in the right eye. Biomicroscopy showed a nongranulomatous anterior uveitis. Fundoscopy revealed the presence of an inactive pigmented chorioretinal scar located on the papillomacular bundle of the left eye, associated with a solitary inflammatory focus adjacent to the scar, without remarkable vitritis. Pupil response, extraocular movements, and intraocular pressure results were normal.
The most likely diagnosis is
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Toxocara retinochoroiditis
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Fungal endogenous endophthalmitis
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Toxoplasma retinochoroiditis
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Cytomegalovirus retinitis
Answer on page 1419
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