Labs, Signs, History-unravelling the TORCH Mystery!

TORCH infections have variable clinical presentation and are caused by various organisms. A 29 y/F came with chief complaint of sudden and painless diminution of vision in right eye(RE) since 2 months when she was pregnant. She gave history of intrauterine fetal death one month back. Distant visual acuity was 6/36 in RE and 6/36 in the left eye (LE). Posterior segment examination revealed vitritis, resolving subhyaloid bleed anterior to macula, patch of retinochoroiditis along inferior arcade with exudates at macula and early macular star in RE. The labs showed reactive Toxoplasma IgG and IgM, CMV IgG reactive and HSV 1 and 2 IgG positive. At follow up, posterior segment of RE revealed significant resolution of retinal pathology. Therefore, TCH infections should be ruled out in a reproductive aged female presenting with unilateral blurring of vision.