Ocular toxoplasmosis is the leading cause of infectious retinochoroiditis in both adults and children. It is caused by the obligate intracellular parasite, Toxoplasma gondii. It is a common cause of posterior uveitis and focal retinitis, typically seen in immunocompetent individuals as a primary infection or in immunocompromised individuals as reactivation of latent infection. Here, we report a rare case of a 29-year-old immunocompetent female presenting with gradual, painless diminution of vision in the left eye associated with headache for over one month. She had a history of hypertension but no other significant medical history. On ocular examination anterior segment was unremarkable and fundus examination of left eye showed "Headlight in fog appearance" suggestive of vitritis. Serological evaluation revealed positive for Toxoplasma IgG antibodies. The patient was treated with cotrimoxazole, oral prednisolone, and topical steroids for 4-6 weeks. Following treatment, her visual acuity improved to 6/6 in left eye. This case highlights the importance of considering ocular toxoplasmosis in the differential diagnosis of unilateral vitritis, even in immunocompetent patients.
Tamoxifen, an oral medication that blocks estrogen activity, is frequently prescribed for the treatment of advanced breast cancer and as an additional therapy following surgical removal of early stage disease. A 45-year-old female with a history of breast carcinoma treated with tamoxifen presented with sudden onset bilateral visual impairment for 4 days. On ocular examination, the patient exhibited optic disc edema with hyperemia and bilateral anterior pathway defects in visual evoked potentials. Magnetic resonance imaging revealed a thickened right optic nerve sheath with patchy enhancement of the left optic nerve sheath. The patient was diagnosed with bilateral optic neuritis and treated with intravenous methylprednisolone, which resulted in significant improvement in visual acuity and resolution of optic disc edema. This case underscores the importance of vigilant ophthalmological monitoring in patients undergoing tamoxifen therapy to facilitate the early detection and management of ocular complications.