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Suggest treatment for ocular toxoplasmosis

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Posted on Mon, 16 May 2016
Question: hi I am in need of advice , I had a recent reactive ocular toxoplasmosis in may and in Oct went dormant at beg of this I had a black line in center of vision in Oct it was only in corner by XXXXXXX it was back in center and has been since then I also experience pain in back of eye that doesn't go away I was told by three doctors this has nothing to do with toxoplasmosis and the scars are not in center of vision I went today to a neuro optamologist and now being told it is just from scarring , I am lost as to what to believe now. can the scarring cause this and what could pain be from Dr today could not tell me what pain was coming from she acted as if I was lying until she did visual felid test and seen I can't see middle and below part of eye
doctor
Answered by Dr. Muhammad Sareer Khalil (11 hours later)
Brief Answer:
Explained in detail

Detailed Answer:
Hello and welcome

Your concern is appreciated

Toxoplasmosis is caused by intracellular protozoan parasite toxoplasma gondii.
It causes significant inflammation and as result scarring in long term which can temporarily or permanently impair vision.
People who are newly infected about 80% of it has no symptoms most of time disease is self limited and dont require treatment.
Chorioretinal scars are genrally inert but the encysted toxoplasma can reactivate causing inflammation, pain, redness
Sensitvity to light, blurred vision, and increase intraocular pressure.
The inflammtion result in localized scar which contain inactive organisms these scars dont affect vision unless involves central portion of retina
It can cause eye pain and bright light can increase the pain.
In addition it can affect brain lung heart or liver people can have headache fever confusion and other neurological problems

The reactivation of the disease should be excluded
Thorough Eye exam slit lamp examination is needes
Fluorescein angiography and ICG can also de done

You can discuss this with your doctors

Hope it helps

please consult your doctor before taking any further course of action

Wishing you best of health

Thanks

Dr M.S Khalil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (5 hours later)
what do u mean by to check for reactivation can u explain that a little more to me please doctors are telling me it's not active in retina, also is there a chance that if this was not treated properly could this have done the damage? I'm sorry for all the question I just don't know if I trust the neuro optamologist I saw, and I had my retina specialist tell me this had nothing to do with toxoplasmosis so I don't know who to believe him or the neuro optamologist
doctor
Answered by Dr. Muhammad Sareer Khalil (3 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

Toxoplasmosis can cause scarring and can result in temporarybor permanent damage to retina. And vision is affected when it involves central portion of retina.
About treatment 80% of people dont develop symptoms; disease is self limited and don't require treatment but in remaing it can cause these symtoms eye pain blurred vision floating spots etc
It can cause complication from mild problem in vision to severe vision loss.
Treatment dont cure the condition but forces it to remain in inactive stage.
The parasite remaim in retina in inactive stage encysted form; when immunity is low or any immunocompromised state is present it can reactivate the parasite.
The floaters in eye can give this black line also pull on vitrous by scar in retina can cause damage to the retina
You should discuss with both your doctors as its caused by scarring or not will require detailed slit lamp examination of eye and also it will help in finding any other cause.


Hope it helps

wishing you best of health

Thanks

Dr M.S Khalil


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (13 minutes later)
so is it possible that this may be temporary and can maybe be fixed even though toxoplasmosis is showing not active?
doctor
Answered by Dr. Muhammad Sareer Khalil (2 minutes later)
Brief Answer:
Yes

Detailed Answer:
Yes , that is a possibility.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (3 minutes later)
thank u for giving me some relief, I did have a slit lamp done yesterday I'm sure and at other places I went. I know u said to have that done and discuss with my dr which I plan to but is there anything else I should mention I just want to make sure I am informed more so they can understand the concern I have and not look at me like it's nothing or nothing they can do I really thank u for ur time and advice
doctor
Answered by Dr. Muhammad Sareer Khalil (17 minutes later)
Brief Answer:
Explained

Detailed Answer:
Hello again

It seem to me that there is communication gap between you and your doctors; you should state all your complaints clearly make them understand of your concerns and anxiety its your vision that you are worried about and if they think that its something benign then you should be assured to full satisfaction after detailed and thorough examination. And in the end if any thing else you would like to know you can ask it will be encouraged.

Hope it helps
Thanks.

Dr M.S Khalil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (4 minutes later)
yes I agree I had mentioned this before and at first was just told it would get better which at first it did for 3 months then in December the line in vision came back and been since then. if this is fixable how would u go about treating it , would we treat it with same med as used to treat toxoplasmosis
doctor
Answered by Dr. Muhammad Sareer Khalil (18 minutes later)
Brief Answer:
Explained

Detailed Answer:
Hello again

It deepends on the lesion if its in retina and due to scar then it would be probably there meds will cover any additional damage and if this parasite has in active stage then it will phush to in active and if this line has reversed due to any new inflammation in the retina then meds can possibly revers it. In usual circumstamces the symptoms typically go away within few weeks
if this line is due to any floater then it can get better with time and if this line is due to some damage in vitrous then probably it will need to excise that band of vitrous. The procedure included are laser therapy cryotherapy and virectomy.
The treatment for reactivation in severe cases include antibiotics to reduce inflammation steroid eye drops and sytemic steroids can also be used.

Hope it helps
Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (20 minutes later)
thank u very much and I will get in touch with my dr I have been dealing with this for 7 months now and just ready to get answers rather it's permanent or not as for as damage goes causing the black line in vision I really appreciate ur time
doctor
Answered by Dr. Muhammad Sareer Khalil (3 minutes later)
Brief Answer:
Explained

Detailed Answer:
you are most welcome

let me know if you have any query

If you don't have any other query then kindly close the discussion and rate the answer.

wishing you best of health

Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2909 Questions

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Suggest treatment for ocular toxoplasmosis

Brief Answer: Explained in detail Detailed Answer: Hello and welcome Your concern is appreciated Toxoplasmosis is caused by intracellular protozoan parasite toxoplasma gondii. It causes significant inflammation and as result scarring in long term which can temporarily or permanently impair vision. People who are newly infected about 80% of it has no symptoms most of time disease is self limited and dont require treatment. Chorioretinal scars are genrally inert but the encysted toxoplasma can reactivate causing inflammation, pain, redness Sensitvity to light, blurred vision, and increase intraocular pressure. The inflammtion result in localized scar which contain inactive organisms these scars dont affect vision unless involves central portion of retina It can cause eye pain and bright light can increase the pain. In addition it can affect brain lung heart or liver people can have headache fever confusion and other neurological problems The reactivation of the disease should be excluded Thorough Eye exam slit lamp examination is needes Fluorescein angiography and ICG can also de done You can discuss this with your doctors Hope it helps please consult your doctor before taking any further course of action Wishing you best of health Thanks Dr M.S Khalil.