From Misdiagnosis to Management: A Case Report of Ocular Inflammatory Disease

TL;DR

A 17-year-old girl with ocular symptoms was initially misdiagnosed but later found to have ocular toxoplasmosis, highlighting the need for accurate diagnosis to prevent vision loss.

Contribution

The case highlights the diagnostic challenges and management of ocular toxoplasmosis with atypical presentations.

Findings

The patient was initially misdiagnosed with optic neuritis but later found to have ocular toxoplasmosis.

Treatment with sulfamethoxazole-trimethoprim led to symptom improvement after initial corticosteroid therapy failed.

Ophthalmoscopic and optical coherence tomography findings confirmed retinochoroiditis consistent with OT.

Abstract

Ocular inflammatory diseases encompass a spectrum of conditions characterized by inflammation within the eye, presenting diagnostic challenges and necessitating tailored management. Ocular toxoplasmosis (OT) poses a challenge in diagnosis and management due to its diverse clinical presentations. We present a case report of a 17-year-old female adolescent who presented with blurred vision and ocular pain, initially misdiagnosed as optic neuritis. Despite receiving methylprednisolone, her symptoms persisted, prompting further evaluation. Ophthalmoscopic examination revealed a whitish focus of chorioretinitis adjacent to an old scar, indicative of OT. Optical coherence tomography confirmed retinochoroiditis, and sulfamethoxazole-trimethoprim was added, resulting in improvement.

This case underscores the importance of considering OT in the differential diagnosis of ocular manifestations, especially in individuals with relevant family history, despite atypical presentations. Timely recognition, accurate diagnosis, and prompt initiation of appropriate therapy are crucial to preserve patients’ visual function.

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