Young children and older adults also may be affected. In some patients, the disease may be asymptomatic with the characteristic changes found only on routine eye examination. Pupils - A relative afferent pupillary defect may be noted. Anterior segment findings reveal normal conjunctiva or conjunctival injection, ciliary flush, anterior chamber cells and flare, fine keratic precipitates, and small hypopyon. Retinitis is the most characteristic feature of this syndrome.
Lesions typically resolve without any ophthalmoscopic or angiographic evidence of damage.
To localize the worm, careful and repeated examination with fundus contact lens is required. The worm can be present in all layers of the retina, but it most frequently is found in the subretinal or outer retinal layers. The motile worm is more likely to be observed in the neighborhood of the active grayish-white retinal lesions. These organisms propel themselves by a coiling and uncoiling motion and sometimes move in a snakelike fashion in the subretinal space. They may be noted to move under direct observation in an apparent aversion to bright light, and a white glistening sheen may be noted over the region.