Editorials

Toxoplasma and the eye

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6986.1021 (Published 22 April 1995) Cite this as: BMJ 1995;310:1021
  1. J Hay
  1. Senior research scientist Consultant ophthalmologist Tennet Institute of Ophthalmology, Western Infirmary, Glasgow G11 6NT
  1. G N Dutton
  1. Senior research scientist Consultant ophthalmologist Tennet Institute of Ophthalmology, Western Infirmary, Glasgow G11 6NT

    Diagnosis, treatment, and prevention are all difficult

    The dual role of small rodents and domestic cats in the natural course of toxoplasma infection has been known for some 25 years,1 but the nature of the interplay between the protozoan and its human host remains elusive. Nowhere is this more evident than in ocular toxoplasmosis.

    Active peripheral toxoplasmic retinochoroiditis may impair vision in the short term because of deposition of inflammatory debris in the vitreous humor. Involvement of the macula or optic nerve may result in permanent visual loss in one eye, or occasionally both eyes. Ocular infection with toxoplasma is one of the commonest causes of postnatal posterior granulomatous uveitis in immunocompetent people, accounting for between a third and a half of cases in the West. Despite this frequency and considerable research, strategies for accurate diagnosis and effective treatment have yet to be devised.

    Although toxoplasma was first observed in the eye of an infant in 1923, focal retinochoroiditis in adults was usually considered to result from tuberculosis or syphilis until tissue cysts containing toxoplasma were found in the retinas of enucleated eyes.2 Since then toxoplasmic retinochoroiditis has remained primarily a clinical diagnosis dependent on the characteristic clinical appearance in …

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