FP628

Silent Ocular Toxocariasis - a mystery unraveled

Purpose: To report a case of Ocular toxocariasis with unique presentation 
Case history:  11-year-old girl presented with complaints of vomiting, headache and inability to stand for 2 days. On examination neck rigidity and hypotonia of lower limbs noted.  Pyogenic meningitis/demyelination was suspected and referred to ophthalmology in view of Neuromyelitis optica.  CSF analysis showed Eosinophilia. MRI brain revealed encephalomyelitis, NMO panel was negative and other possible causes were investigated. 
Ocular examination showed BCVA 6/6 OU, normal anterior segment. Fundus examination OS showed healed chorioretinitis patch with vitreous condensation and localized traction in the superotemporal quadrant, suggestive of ocular toxocariasis. Serum ELISA for Toxocara Excretory Secretory antigen was positive. The child received Albendazole for 14 days and symptomatically improved.
Conclusion: Ocular toxocariasis may not always present with visual complaints and can manifest systemically.