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Case Quiz: Starry Starry Sight

The case – Starry Starry Sight – is shared by Charmaine Grace P. Malabanan, Southern Philippines Medical Center, Philippines.

Description: A 55-year-old female, previously admitted for typhoid fever, presented with a sudden onset, painless blurring of vision of the left eye. She was managed as a case of post-typhoid neuroretinitis. After treatment, visual acuity improved with resolution of disc edema.


1. How is typhoid fever transmitted?

A. Contaminated food and water
B. Mosquito bite
C. Direct invasion
D. Air droplets

2. What laboratory work-up is the diagnostic method of choice for typhoid fever?

A. Bone marrow aspirate
B. Polymerase chain reaction
C. Blood culture
D. Widal test

3. Which typhoid-related ocular manifestations would you expect to see during the post-fever stage?

A. Optic nerve head edema
B. Neurosensory detachment
C. Focal or multifocal retinitis with macular star
D. All of the Above

4. Diagnosis of post-typhoid neuroretinitis is usually done through:

A. Laboratory work-up
B  Clinical history and physical examination
C. Fluorescein angiography
D. Biopsy

5. Treatment of post-typhoid neuroretinitis is:

A. Piperacillin + Tazobactam
B. Steroids
C. Ceftriaxone
D. Carbonic anhydrase inhibitors

The Case Reports in Ophthalmology Meeting has been organized by the Foundation for the Development of Ophthalmology “Ophthalmology 21,” together with the University of Warmia and Mazury in Olsztyn, Poland, since 2016. This online global meeting features short, puzzle-like, educational case reports. We are very happy to share the most interesting cases with The Ophthalmologist in quiz form.  
The Case Reports in Ophthalmology Meeting 2023 is scheduled for November 17, 2023, and is open for case submission and registration: [email protected].

A co-organizer from The Philippines, Perfecto Cagampang III, comments, “The Case Reports 2022 virtual conference organized by Foundation ‘Ophthalmology 21’ – with its participatory nature – has been an excellent platform for ophthalmology residents to hone their skills of presenting cases in an eloquent manner.”

Andrzej Grzybowski, CEO, Foundation “Ophthalmology 21.”


1. A – Contaminated food and water

2. C – Blood culture

3. D – All of the Above

4. B – Clinical history and physical examination

5. B – Steroids

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About the Author
Andrzej Grzybowski

Andrzej Grzybowski is a professor of ophthalmology at the University of Warmia and Mazury, Olsztyn, Poland, and the Head of Institute for Research in Ophthalmology at the Foundation for Ophthalmology Development, Poznan, Poland. He is EVER President, Treasurer of the European Academy of Ophthalmology, and a member of the Academia Europea. He is a member of the International AI in Ophthalmology Society ( and has written a book on the subject that can be found here:

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