The eye finding most characteristic of a pre-natal, and therefore, congenital infection is a chorioretinal scar or an active chorioretinitis as can be seen in congenital toxoplasmosis, CMV, HSV, lymphocytic choriomeningitis virus, or varicella zoster infections. Congenital cataracts are suggestive, but less specific for congenital infection. They may be a relatively isolated finding in rubella, syphilis, varicella zoster, and Epstein-Barr virus infections. When they are present in congenital toxoplasmosis, HSV, and CMV, they are associated with extensive eye involvement. Other manifestations are less common as discussed above. The mechanism of action of these agents appears to be both a direct toxic and a teratogenic effect.
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