This view is of the optic disc and temporal retina
The main clinical features are:
- Pigmented clumps in macular area with chorio-retinal atrophy and scarring
- Pallor of the optic disc is noted indicating atrophy
This diagnosis is consistent with:
MACULAR SCAR (TOXOPLASMOSIS)
Comment:
- The cat is a definitive host for Toxoplasma gondii. This is usually a quiescent lesion often discovered incidentally when a child is assessed for impaired vision. An active lesion may show an inflammatory focus with a vitreous haze adjacent to a previous scar and vasculitis.
- There may be associated anterior uveitis.
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FY2 Gp
55yr old woman
Blurry vision for 3/52
PMR on steroids
Has multiple cats as pets
Takes care of cat poo with bare hands
Exam findings; Tendochoroniditis + dilated vessels on fundoscopy
Mgt
Send to specialist
Advise about taking care of cats poo
48 yr old Laura Parker comes to GP surgery with complaints of blurring of vision for the past one month.
DOs
Which eye? What about the other eye
Ask for trigger
Ask for atleast 3 dds
Immunocompramised or not. In this case patient has PMR and is in steroids
ASK FOR PETS (Cats)
Be familiar with all eye slides
DONTS
Dont straight away jump to phycosocial Hx. Go with the flow Dont spend more than 3 minutes in Hx as its a combined station
Dont ever forget to ask ICE and explain the diagnosis.
Dont forget safety net, Follow up, leaflet
MANAGEMENT
Advice about hygiene while handling food.Cooking
Extra careful with cat poo and take cat to vet
Involve senior and refer to specialist if immunocompramised
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