Parainfectious optic neuritis arises from infectious aetiology either from pathogen direct invasion or after an infectious disease which can be immunologically mediated demyelination of optic nerve or, from inflammation of optic disc vasculature. We report a case of bilateral optic neuritis in a young patient. A 13year-old boy presented with painless profound vision loss in both eyes preceded by an episode of fever two weeks prior. Visual acuity in both eyes was a perception of light. Fundoscopy showed a bilateral hyperemic swollen disc. Blood investigations were normal except for C-reactive protein and ESR was elevated. CSF analysis was also normal with no growth of micro-organisms. Both CT scans and MRIs of the brain and orbit showed normal findings. The patient was diagnosed to have parainfectious optic neuritis. He was started on intravenous methylprednisolone for five days followed by a tapering dose of oral prednisolone for a total of one month. His final visual acuity improved to 6/6 in both eyes with a normal optic disc appearance.

Fungal infections always pose a predicament to management and prognosis. The saprophytic fungus, Trichosporon inkin commonly causes endogenous infection in immunocompromised individuals. We report a case of exogenous T. inkin endophthalmitis successfully treated with voriconazole, pars plana vitrectomy, and removal of the source of infection. A 51-year-old gentleman with suboptimal control of diabetes presented with a right painful red eye for a week after undergoing an uneventful phacoemulsification with a posterior chamber intraocular lens implant more than a month prior. He presented with intense inflammation in the right anterior chamber that did not respond to steroid challenge. Ultrasound B scan showed vitreous opacities with no loculations. The culture of vitreous humor was negative. Systemic investigations were also normal. Despite being given multiple intravitreal antibiotics, his right eye got worse. He then underwent vitrectomy and intraocular lens explantation, in which the culture of the lens grew Trichosporon Inkin. He was subsequently started on the appropriate antifungals (topical, intravitreal, and systemic) based on the minimum inhibitory concentration of the antifungal sensitivity test. The patient eventually showed significant clinical improvement, and intraocular inflammation was subsiding after six months of treatment. His best corrected visual acuity improved to 6/12 with Snellen's visual acuity chart.