Blinded by the Unseen: An Uncommon Posterior Pole Variant of Ocular Toxocariasis in an Adult without Pet Exposure

Abstract

Background: Ocular toxocariasis (OT) is an infrequent parasitic infection typically affecting children, with posterior pole involvement being particularly uncommon. Adult presentations without a clear history of pet exposure complicate early recognition and clinical suspicion.
Case Presentation: We present the case of a 31-year-old woman from Barabanki, Uttar Pradesh, with unilateral ocular pain, photophobia, and progressive visual disturbance over one month. Prior empirical therapy was ineffective. Ophthalmic evaluation revealed a large elevated whitish posterior pole lesion with surrounding pigmentary changes, vitreoretinal traction bands, mild disc hyperemia, and distortion of the retinal vasculature, characteristic of posterior pole OT. Her right eye remained unaffected. Systemic and ocular history were unremarkable for risk factors such as cat/dog exposure.
Conclusion: This case highlights the diagnostic challenge of adult-onset posterior pole OT in the absence of typical epidemiologic clues. Recognition of hallmark fundus features, supported by targeted serology and imaging, is essential for preventing irreversible visual consequences.