56 year old black male who has a history of "hemorrhaging" into both eyes in 1953. There has been no prior history of eye problems. He states that his vision has remained very poor since 1953.
His best corected visual acuity now is 20/200 O.U. wearing -2.50 sphere O.U.
Three years ago he states that diabetes was diagnosed and that the only therapy has been a restricted diet.
Photographs reveal bilateral peripapillary involvedment with associated extensive macular changes. There are also punched out areas in the periphery of both eyes.
There is no significant family history. The only other eye finding is moderate nuclear sclerosis O.U.
The patient has a strongly positive histoplasmin skin test > 25 mm of induration.
It is presented as a possible rare case of presumed ocular histoplasmosis occuring in a black individual with associated macular changes.