| Summary: | Acute retinal necrosis (ARN) is a rare, blinding disease that typically affects
adults. However, in this case report, we highlight the diagnosis, management and
outcome of herpes simplex acute retinal necrosis in a 13-year-old healthy girl,
who presented with painful right eye, redness and blurring of vision for one week.
Examination of the right eye showed features of granulomatous panuveitis. Optic
disc was swollen and retina appeared pale. There were multiple patches of retinitis
and haemorrhages at mid-periphery of the fundus with inferior serous detachment
observed. Rapidly progressive inflammation in just four days along with secondary
cataract that obscured fundus view, imposed greater challenge to the diagnosis
and management. Intravenous acyclovir 300mg, 3 times a day was initiated
promptly while vitreous fluid was sent for polymerase chain reaction, which
identified Herpes Simplex Virus-1. Inflammation improved, but she developed
vitreous haemorrhage secondary to proliferative retinopathy, which required
panretinal photocoagulation. ARN is therefore, principally a clinical diagnosis and
high index of suspicion is crucial particularly, in children for prompt diagnosis and
treatment. Complications should also be addressed timely to improve the chances
of preserving vision.
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