A case of diffuse unilateral subacute neuroretinitis in a ch
Diffuse unilateral subacute neuroretinitis (DUSN) is a rare cause of posterior uveitis that typically presents unilaterally in children and young adults but rarely bilateral cases have been reported. It is also rare to have multiple worms in the same eye causing the clinical picture.

In this article, published in BMC Ophthalmology, the authors present a challenging case of DUSN in a young girl unresponsive to conventional treatments suggesting the possibility of multiple worms being present in the same eye.

An 8-year-old girl presented with a 2-month history of headaches. On occasions the headaches were associated with redness and watering of her left eye. She denied any visual loss or visual symptoms. Her visual acuity was reduced to 6/30 in her left eye. Fundal examination revealed a unilateral chorioretinitis. Investigation did not reveal a specific cause for the chorioretinitis.

Over 15 months her visual acuity improved to 6/9 but the fundal appearance changed and a diagnosis of DUSN was made. She was treated with focal laser, systemic anti-helminthic and immunosuppressive treatments but continued to develop new, active areas of chorioretinitis, raising the possibility of multiple worms in the sub-retinal space. There was also a concern as to other central nervous system (CNS) involvement given her significant and ongoing headaches.

Learning Points:-
This case highlights the difficulties often encountered in the treatment of DUSN, even when a worm can be identified. Her visual prognosis was poor as there was ongoing recurrence of active chorioretinitis.

Read in detail here: https://pxmd.co/AmUvi