Brief Answer:
Need more information

Detailed Answer:
Hello and welcome

I appreciate your concern

Kindly answer the following to advise accordingly

Is this the first time that you have experienced these visual symptoms in association with the reactive toxoplasmosis diagnosis that you mentioned or have these been occurring previously
Since when have you noticed that black spot.
If possible kindly upload the toxoplasmosis labs to have a better idea.
What medications are you currently using.
Do you have any co morbid condition / disease history in the past besides this.

let me know if you have any query

wishing you best of health

Thanks

Dr M.S Khalil

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Brief Answer:
Explained

Detailed Answer:
Hello again

Toxoplasmosis a parasitic disease caused by toxoplasma gondii it usually causes no symptoms in adult humans with good immune system. Typically testing the blood for antibodies is done for diagnosis. In latent infection toxoplasmosis enters a latent phase in which only tissue cysts are present. These cysts can occur in retinas, alveolar linings of lungs, heart , skeletal muscle and central nervous system. Cyst formed in CNS persist for life time of the host. Eye infection leads to acute inflammatory lesion of retina which resolves having retinocchoridal scarring. The eye disease can reactivate months or years later each time causing more damage to retina. Area of acute onset inflammation near to an old chorio retinal scar is virtually pathognomonic for toxoplasma. The disease is asymptomatic in immune competent patients and is benign and self limiting but may be more severe in fetus and immune compromised patients. Clinical presentation in ocular disease depends on age, location and severity of chorioretinitis and include floaters and blurred vision. Decreased visual acuity is caused by macular involvement and vitreous inflammation. Retinal vasculitis may be present in the vicinity of active lesion. disease is recurrent in 2/3rd of patients. So the point is it may be again an active infection or reactivation. In immune compromised people there is atypical presentation like large confluent areas of retinochoridal necrosis and active bilateral lesions. Optic neuritis punctate outer retinitis papilitis and pseudo retinitis. It seems to me that there is reactivation of the lesion that could potentially be causing more damage to the eye. Other differential diagnosis with this presentation can include glaucoma, macular degeneration, retinal detachment, optic neuritis, temporal arteritis.
Systemic causes may include sarcoidosis, tuberculosis , ocular toxocariasis, syphilis, septic retinitis, fungal retinitis , necrotizing retinitis due to CMV, herpes zoster. With previous history of toxoplasma slit lamp examination should be advised. You may discuss these options with your doctor.

Wishing you best of health

Please consult your doctor before taking any further course of action

Thanks

Dr. M.S Khalil.

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Brief Answer:
Explained

Detailed Answer:
Hello again.

Your question that how optic neuritis is diagnosed you would have to see an opthalmologist for diagnosis he would first do routine eye exam, opthalmosocopy, pupillary light reaction test, he can also do visual evoked response , MRI scan.
The symptoms for optic neuritis is that most people develop pain which worsen with eye movements there is vision loss but extent of vision loss varies there may be loss of colour vision some people complaint of flashing or flickering lights it may be difficult to see at night due to difficulty with contrast and glare.
Another thing is symptoms of active toxoplasmosis include floaters and blurred vision. As you should know generally ocular toxoplasmosis present as focal necrotising retinitis and its generally assoiates with vitritis ( inflammation of vitrous) and anterior uveatis. Less commonly may present as papillitis.
The complications of ocular toxoplasmosis onclude chronic irridocyclitis, secondary glaucoma, band keratopathy, cystoid macular edema, optic atrophy, retinal detachment , peribhlebitis, branch artery occlusion.
Opthalmic examination will clear it out if its diificult to reach a definite diagnosis on this then detection of increased T gondii antibody titers in ocular fluids or amplification of T gondii have been used for diagnosis.

wishing you best of health

Thanks

Dr M.S Khalil.

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Brief Answer:
Explained

Detailed Answer:
Hello again.

I answered the previous questions, keeping in mind as if you were my patient. As I stated before, I would go for routine eye exam, opthalmosocopy, pupillary light reaction test, he can also do visual evoked response. Detection of increased T gondii antibody titers in ocular fluids or amplification of T gondii should be used, subsequently.


wishing you best of health

Thanks

Dr M.S Khalil.

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Brief Answer:
Most welcome

Detailed Answer:
You are most welcome

Hope I have answered your query.

If you have any further questions I will be happy to help If you do not have any clarifications, you can close the discussion and rate the answer.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

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