Ocular Toxocariasis in a Seronegative Adult

Ocular nematodal infections typically affect children. This article demonstrates the utility of enzyme-linked immunosorbent assay (ELISA) testing of the aqueous humor and vitreous to aid the diagnosis of ocular toxocariasis in adults. A 62-year-old woman presented with a 2-year history of worsening vision in her left eye. Examination of the fundus revealed tractional membranes over the optic nerve and nasal retina. Serologic evaluation was unrevealing. The patient was referred to the Bascom Palmer Eye Institute for an anterior chamber ELISA, which was positive for Toxocara. A vitrectomy and scleral buckling procedure was performed. The patient achieved anatomic success after surgery, but her visual acuity in the left eye remained hand motions. This case highlights the importance and utility of ELISA testing of the anterior chamber fluid and/or vitreous aspirate for ocular toxocarasis. This patient is among the oldest described to have active ocular toxocariasis.