An 8-year-old girl presented with headache and eye strain for one week. History and clinical examination were normal. Ophthalmic examination showed anisometropia, normal intra-ocular pressure and fundus showed focal healed scars of central chorioretinitis close to the macula in right eye (Fig. 1). Toxoplasma serology (IgG) was positive for patient and her mother. Unilateral chorioretinitis can occur in both congenital and acquired toxoplasmosis but presence of anisometropia makes vertical transmission more likely. Ocular involvement in the form of focal necrotizing chorioretinitis and central nervous system lesions develop by adolescence in untreated patients. Other ocular manifestations include optic nerve involvement, vitritis, anterior uvitis and retinal detachment. Majority will have severe visual impairment. Characteristic retinal lesions and positive serology helps in diagnosis. Recurrent or progressive disease can occur because the encysted form of organisms persists throughout life. Suppressive treatment with pyrimethamine, sulfadiazine and folinic acid prevents frequent recurrences of lesions.

Fig.1 Scars of healed central chorioretinitis (arrows).