II. Epidemiology

  1. Age of onset: 5-8 years old (mean)
  2. Incidence: 700 cases per year in United States

III. Pathophysiology

  1. Roundworm infection (Toxocariasis)
  2. Spreads to eye from concurrent Visceral Larva Migrans

IV. Symptoms

  1. Gradual or sudden unilateral visual loss
  2. Eye discomfort
  3. Symptoms of Visceral Larva Migrans often absent
  4. Strabismus

V. Signs: Slit Lamp Exam

  1. Leukocoria
  2. Endophthalmitis
  3. Choroidal Granuloma (subretinal Granulomatous mass)
  4. Posterior pole Granuloma
  5. Peripheral Granuloma with traction bands

VI. Labs

VII. Differential Diagnosis

  1. Retinoblastoma
  2. Strabismus
  3. Exudative retinitis (Coat's disease)

VIII. Complications

  1. Ocular inflammation with scarring with risk of Vision Loss

IX. Course

  1. Ocular symptoms may present up to 10 years after infection

X. Management

  1. No satisfactory treatment
  2. Trial of Corticosteroids
  3. Surgery may be indicated in severe cases
  4. See Visceral Larva Migrans

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