A 31-year-old man with vitritis, chorioretinitis, and hydrocephalus

Abstract

A 31-year-old man presented to the emergency department of the Massachusetts Eye and Ear Infirmary with a chief complaint of blurry vision and redness in his right eye of 1 week's duration. He was a native of Brazil, and the history and examination were performed with the aid of a Portuguese interpreter. The patient was in his usual state of excellent health preceding the episode. He reported mild pressure in the affected eye along with a constant, bilateral, temporal headache that may have predated the blurred vision. The headache was readily relieved by acetaminophen. He denied flashes, photosensitivity, or other visual aberrations. He maintained that his vision was "weaker" on the right at baseline. On further questioning, he felt that his symptom was best characterized as "many floaters" in the right eye. He believed he may have been exposed to a toxic chemical at his workplace 2 months prior to this presentation. The patient's past medical history was unremarkable. He had no known drug allergies, and he denied a family history of medical or surgical conditions. His social history was significant for the use of occasional alcohol. He denied high-risk sexual activities, intravenous drug use, and blood transfusions.