-
Views
-
Cite
Cite
A 33-Year-Old Man with a White Pupil, Clinical Infectious Diseases, Volume 43, Issue 8, 15 October 2006, Pages 1043–1044, https://doi.org/10.1086/507892
Close - Share Icon Share
Extract
A 33-year-old man with mental retardation was referred to an ophthalmology clinic in Maryland for evaluation of his left eye, which had been hyperemic with a “white spot” for 2 months. There was no history of ocular trauma or prior infections. There were no sick patient contacts, and the patient had no history of travel outside of Maryland. The patient's family had 2 dogs at home. The patient's mother suspected that a foreign object may have penetrated his left eye while he was playing outside in the yard. She also reported subjective intermittent fevers without any other systemic or behavioral changes.
At examination, the patient was unable to fixate and follow with his left eye. His left pupil was not reactive to light and was noted to be leukokoric. The findings of an evaluation of the right eye were normal. The left eye was hypotonous (intraocular pressure, <10 mm Hg) with a hyperemic conjunctiva, shallow anterior chamber, and white pupillary membrane (figure 1). Orbital ultrasound revealed a total retinal detachment with underlying dense subretinal opacities and possible fluid behind both optic nerves, raising suspicions of increased intracranial pressure (figure 2; an orbital ultrasound of the patient's healthy right eye is shown for comparison). A sample of aqueous fluid was sent for analysis. The patient was electively admitted to the hospital for further management of possible increased intracranial pressure.
