Ocular involvement occurs by hematogenous spread of the bacteria, and symptoms may vary from the mild pain and redness of anterior uveitis to the severe pain and decreased vision of panophthalmitis. Nocardia infection can affect essentially any ocular structure, including periorbital tissue and the adnexae. Findings range from keratitis, necrotizing scleritis, or an isolated, unilateral choroidal or subretinal mass (abscess) with minimal vitritis to panuveitis with anterior chamber cell and flare, vitritis, and multiple choroidal abscesses with overlying retinal detachment mimicking fungal endophthalmitis.
Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.