Figure 2.16. Rubella cataract is the most common ocular finding in infants with congenital rubella and occurs in up to 75% of these infants. Classically, the cataract is nuclear, and the virus can be isolated from the lens for years following birth.
Figure 2.17. Rubella retinitis appears as a salt and pepper retinitis classically and reflects damage to the retinal pigment epithelium. It can be present without any decrease in visual acuity.
Figure 2.19. Toxoplasmosis may cause a large macular chorioretinal scar. This is the most typical lesion of toxoplasmosis infection, but it is indistinguishable clinically from a large macular chorioretinal scar of cytomegalovirus infection.
Figure 2.20. Cytomegalovirus was the cause of this large macular chorioretinal scar. It closely resembles the scar of toxoplasmosis shown in Figure 2.19.
Figure 2.21. Cytomegalovirus may cause a coloboma of the optic nerve. This failure of the fetal fissure to fuse posteriorly may occur in infants with cytomegalovirus infection. When there is ocular involvement in cytomegalovirus infection, there is usually damage to the central nervous system.
Figure 2.22. Cytomegalovirus may cause hypoplasia of the optic nerve. This lack of development of the optic nerve in infants with cytomegalovirus infection may be associated with severe damage to the central nervous system.
Figure 2.23. Herpes simplex infection can be devastating not only to the eye but to the central nervous system. Occasionally, a superficial herpetic corneal ulcer with edema, as shown in this figure, can allow rapid diagnosis of herpetic infection with the opportunity to institute systemic therapy immediately.
Figure 2.24. This herpes simplex corneal ulcer with dendrites, shown unstained Figure 2.23, is stained with fluorescein and viewed with a cobalt blue filter. Such a corneal lesion allows early diagnosis. If dierapy is begun immediately, herpes simplex infection does not necessarily correlate with severe central nervous system damage.
Figure 2.25. Herpes simplex can cause a necrotizing chorioretinitis. It usually appears within the first few days following birth as macular or peripheral retinal edema.
Figure 2.26. Herpes simplex necrotizing chorioretinitis usually progresses rapidly and usually correlates with severe central nervous system necrosis. This is the same eye as in Figure 2.25, 4 days later.
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