Chorioretinitis is swelling and irritation (inflammation) of two important layers at the back of the eye: the choroid (a layer rich in blood vessels) and the retina (the light-sensitive layer that lets you see). Because both are inflamed together, doctors call it “chorioretinitis” or “retinochoroiditis.” It is a form of posterior uveitis, meaning the inflammation is in the back part of the eye.
Chorioretinitis is inflammation at the back of the eye, in the choroid (layer with blood vessels) and the retina (light-sensing tissue). It is often caused by infection (like toxoplasmosis, viruses, TB, syphilis) or autoimmune disease. Treatment always has two goals: control the infection (if present) and calm the inflammation to protect vision.
Because vision loss can be permanent, decisions about medicines, doses, and timing must be made by an eye specialist (ophthalmologist) and often an infectious-disease or rheumatology doctor. The information below is general education, not a self-treatment plan.
When these layers are inflamed, they can swell, leak fluid, and get damaged. This can blur vision, cause dark spots in the sight, or even lead to permanent loss of vision if not treated in time. Chorioretinitis can affect one eye or both eyes, and it can come on suddenly (acute) or develop slowly and last for a long time (chronic).
Many cases are caused by infections spreading to the eye from the blood, such as the parasite Toxoplasma gondii, viruses like cytomegalovirus (CMV), or bacteria like those causing tuberculosis or syphilis. Sometimes, it happens because the immune system attacks the eye by mistake, or because of trauma, tumors, or unknown reasons.
Other names and types of chorioretinitis
Doctors may use a few other names for the same or closely related problems. You might see the terms “retinochoroiditis,” “posterior uveitis,” “chorioretinal inflammation,” or “ocular toxoplasmosis” (when the cause is the parasite Toxoplasma gondii). These terms all describe inflammation that involves the retina and choroid at the back of the eye.
Chorioretinitis can be grouped into several simple “types” based on different features:
Infectious chorioretinitis – caused by germs such as parasites, viruses, bacteria, or fungi.
Non-infectious (immune-mediated) chorioretinitis – caused by autoimmune or inflammatory diseases, not by germs.
Congenital chorioretinitis – present in a baby at birth, usually from an infection passed from the mother during pregnancy (for example congenital toxoplasmosis or congenital CMV).
Acquired chorioretinitis – starts later in life, after birth, due to infection, immune disease, or other triggers.
Acute chorioretinitis – starts suddenly with new symptoms and active inflammation.
Chronic or recurrent chorioretinitis – inflammation continues for months or keeps coming back after it seems better.
Focal chorioretinitis – inflammation in one or a few small spots at the back of the eye.
Multifocal or diffuse chorioretinitis – many spots or wide areas of the retina and choroid are inflamed.
Unilateral chorioretinitis – only one eye is affected.
Bilateral chorioretinitis – both eyes are affected at the same time or one after the other.
Causes of chorioretinitis
The causes of chorioretinitis can be grouped into infections, immune diseases, and “other” triggers such as trauma, tumors, or drugs. Many patients have an infection somewhere else in the body, and tiny germs or their toxins travel in the blood to the eye. In other patients, the immune system becomes over-active and attacks eye tissues by mistake. Sometimes, even after testing, the exact cause cannot be found.
Toxoplasmosis infection
A very common cause is infection with Toxoplasma gondii, a parasite that can be picked up from undercooked meat or cat feces, or passed from mother to baby during pregnancy. The parasite forms cysts in the retina and choroid, which can later reactivate and cause “necrotizing” chorioretinitis with white-yellow patches and scarring.Cytomegalovirus (CMV) infection
CMV is a virus in the herpes family. In people with weak immune systems, such as those with advanced HIV/AIDS or on strong immune-suppressing medicines, CMV can cause severe retinitis and chorioretinitis with areas of retinal whitening, bleeding, and a high risk of blindness if not treated.Herpes simplex virus (HSV) and varicella-zoster virus (VZV)
These viruses, which also cause cold sores and shingles, can spread to the eye and cause posterior uveitis with chorioretinitis. The inflammation may appear with patches of retinal damage, blood vessel inflammation, and sometimes associated optic nerve swelling.Syphilis
Syphilis is a sexually transmitted infection caused by Treponema pallidum. It can affect almost any organ, including the eye. Syphilitic chorioretinitis or chorioretinal lesions can appear at different disease stages and may mimic many other eye diseases, so syphilis testing is important in unexplained posterior uveitis.Tuberculosis (TB)
TB, caused by Mycobacterium tuberculosis, can reach the eye from an infection in the lungs or elsewhere. It may cause choroiditis and chorioretinitis, often with yellow-white lesions, sometimes with fluid or bleeding under the retina. A history of TB exposure or lung disease raises suspicion.Fungal infections (for example Candida)
In patients with long hospital stays, intravenous catheters, major surgery, or immune problems, fungi like Candida albicans can spread through the blood to the eye and cause candidal chorioretinitis. People may have eye pain, decreased vision, and white “cotton-ball” lesions.Other parasitic infections (for example toxocariasis, onchocerciasis)
Worm infections such as toxocariasis (from dog roundworm) or onchocerciasis (“river blindness”) can also inflame the retina and choroid. These parasites trigger strong immune reactions, leading to chorioretinitis, scarring, and sometimes severe visual loss in affected areas.West Nile virus and other systemic viral infections
Some mosquito-borne viruses such as West Nile virus can cause chorioretinitis during or after a systemic infection with fever and neurologic symptoms. The eye findings may show small white lesions or “targets” in the retina and choroid.Presumed ocular histoplasmosis
In some regions, exposure to the fungus Histoplasma capsulatum is linked to “presumed ocular histoplasmosis syndrome” (POHS), where old chorioretinal scars and abnormal new blood vessels under the retina may develop. While the exact cause is debated, chorioretinal inflammation is a key feature.HIV infection and other forms of severe immune suppression
HIV itself and medicines that strongly reduce immunity can make people much more likely to get infectious chorioretinitis from CMV, toxoplasma, fungi, or other organisms, because the body cannot control these germs.Congenital infections (TORCH group)
Infections passed from mother to baby before birth, such as toxoplasmosis, rubella, CMV, herpes, and syphilis, can cause congenital chorioretinitis. These babies may have other problems like brain calcifications, hydrocephalus, jaundice, or growth delay along with eye damage.Sarcoidosis
Sarcoidosis is an inflammatory disease where tiny clusters of immune cells (granulomas) form in many organs. When sarcoidosis affects the eye, it can cause uveitis and chorioretinitis, sometimes with characteristic lesions near blood vessels and the optic nerve.Behçet’s disease and other vasculitides
Behçet’s disease is an autoimmune disorder that inflames blood vessels throughout the body. In the eye it can cause posterior uveitis, retinal vasculitis, and chorioretinitis, often with painful mouth and genital ulcers and skin lesions elsewhere.Other autoimmune or inflammatory diseases (such as VKH, IBD-related uveitis)
Conditions like Vogt–Koyanagi–Harada (VKH) disease, inflammatory bowel disease, and other systemic autoimmune disorders can trigger immune-mediated chorioretinitis without infection. The immune system attacks pigment cells and blood vessels in the eye, causing swelling and fluid under the retina.Blunt or penetrating eye trauma
A strong blow, sharp injury, or surgery to the eye can damage the choroid and retina directly. After trauma, inflammation can develop in the injured area or trigger immune responses that extend to other parts of the eye, leading to secondary chorioretinitis.Intraocular tumors or metastases
Tumors in or near the choroid, such as melanomas or metastatic cancers, can disturb local blood flow and release proteins that trigger inflammation. This may look like chorioretinitis on examination, or true inflammation may develop around the tumor.Toxins and drug-induced eye inflammation
Certain toxic substances, including some chemotherapy drugs or medicines that affect the immune system, can damage retinal or choroidal cells or change blood vessels. This may cause secondary chorioretinitis or a uveitis-like picture in sensitive individuals.Post-surgical inflammation and endophthalmitis
After eye surgeries or injections, germs can sometimes enter the eye and cause a serious infection called endophthalmitis, which often includes chorioretinitis. Even without infection, strong post-surgical inflammation may involve the choroid and retina.Systemic sepsis and bloodstream infections
When bacteria or fungi are present in the blood (sepsis), they may “seed” the eye and cause endogenous chorioretinitis. This is seen in very sick patients, often in intensive care, with fever, low blood pressure, or other signs of severe infection.Idiopathic chorioretinitis (cause unknown)
In a small number of patients, even after careful history, examination, blood tests, and imaging, no clear cause is found. These cases are called “idiopathic chorioretinitis.” Doctors still treat the inflammation and watch carefully for any later clues to an underlying disease.
Symptoms of chorioretinitis
Symptoms can be mild at first and may affect only one eye, so people sometimes ignore them. But inflammation at the back of the eye can damage important vision areas like the macula and optic nerve, so any sudden change in vision, new floaters, or eye pain should be checked urgently by an eye doctor.
Blurred vision
Many patients notice that their vision becomes hazy or less sharp. This happens because swelling, fluid, or scarring in the retina disrupts how light is focused, especially if the macula (the central vision area) is involved.Dark spots or “floaters” in the vision
People often see small moving spots, cobwebs, or shadows, called floaters. These come from inflammatory cells, blood, or debris floating in the gel (vitreous) in front of the retina.Sensitivity to light (photophobia)
Bright light may feel very uncomfortable or even painful. Inflammation in the back of the eye makes the retina more sensitive, and light entering the eye triggers discomfort.Eye pain or aching
Some people have a deep, dull ache in or around the affected eye, especially when inflammation also involves the front of the eye (anterior uveitis) or when pressure inside the eye changes.Red eye
The white part of the eye (sclera) may look red or bloodshot because tiny surface blood vessels enlarge as part of the inflammatory response, especially when uveitis extends toward the front of the eye.Loss of central vision
If the macula is affected, reading small print, recognizing faces, or seeing fine details becomes difficult. People may notice that letters are missing or blurred in the center of a page.Loss of peripheral (side) vision
Inflammation or scarring in the outer retina can cause “holes” or gaps in side vision. Patients may bump into objects or feel that their visual world has narrowed, even if central sight is still fairly good.Distorted vision (metamorphopsia)
Straight lines may appear wavy, or objects may look stretched, smaller, or larger than normal. This happens when swelling or scars affect the shape of the retina, especially in the central area.Dark patches or blind spots (scotomas)
People may notice a patch in their vision where they cannot see clearly, such as a grey or dark area in the center or side. These scotomas usually correspond to damaged or scarred areas of the retina.Trouble seeing in dim light
Some patients report that night driving or moving in dark rooms becomes difficult. Inflammation and damage to retinal cells responsible for low-light vision can cause this symptom.Changes in color vision
Colors may look dull, washed out, or different between the two eyes. Involvement of the macula or optic nerve can affect how color signals are processed.Excess tearing or watery eye
The eye may water more than usual. This tearing is a nonspecific response to irritation and inflammation inside the eye and on its surface.Headache or eye-strain feeling
Straining to see with a blurred or painful eye can trigger headaches, especially around the forehead or brow. This is often worse when reading or using screens for a long time.Sudden drop in vision
In some severe cases, vision can drop quickly over hours or days. This may signal extensive inflammation, bleeding, fluid build-up, or complications such as retinal detachment or new abnormal blood vessels, and is an emergency sign.Symptoms of the underlying disease
Many people also have symptoms from the cause of the chorioretinitis, such as fever, fatigue, swollen lymph nodes, rashes, joint pain, mouth ulcers, or cough. These whole-body clues help the doctor find the root cause.
Diagnostic tests for chorioretinitis
Doctors use a mix of eye examination, manual tests, laboratory tests, electrodiagnostic tests, and imaging tests to confirm chorioretinitis and search for the cause. Often, an eye specialist (ophthalmologist) works together with infectious-disease or rheumatology doctors to plan the work-up.
Physical exam tests
Visual acuity test (physical exam)
This is the standard “reading the eye chart” test. It measures how clearly a person can see letters or symbols at a set distance. A drop in visual acuity, especially in one eye, can suggest that the macula or other parts of the retina are affected by chorioretinitis.Pupil light reflex test (physical exam)
The doctor shines a light into each eye and watches how the pupils react. Abnormal or unequal reactions may show that the retina or optic nerve is not working properly, which can occur in severe chorioretinitis or its complications.Eye movement and alignment exam (physical exam)
The doctor asks the patient to follow a target in different directions. If double vision, pain, or restricted movement appears, it may point toward involvement of nerves or extra-ocular muscles, sometimes seen in systemic infections or inflammatory diseases that also cause chorioretinitis.General body examination (physical exam)
A full physical exam looks for fever, skin rashes, mouth or genital ulcers, swollen lymph nodes, lung findings, or neurological signs. These clues suggest infections like toxoplasmosis or TB, or autoimmune diseases like sarcoidosis or Behçet’s disease that can be linked to chorioretinitis.
Manual eye tests
Slit-lamp biomicroscopy with dilated fundus exam (manual test)
The ophthalmologist uses a special microscope (slit lamp) and dilating eye drops to view the front and back of the eye in detail. They can see active white-yellow lesions, scars, bleeding, and vitreous cells that are typical features of chorioretinitis.Indirect ophthalmoscopy (manual test)
With a bright head-mounted light and a handheld lens, the doctor examines the far peripheral retina. This test shows the size, number, and location of chorioretinal lesions, including those in the outer parts of the eye that may be missed on routine exam.Intraocular pressure measurement (tonometry) (manual test)
A small device gently touches or blows air on the eye surface to measure pressure inside the eye. Chorioretinitis can sometimes raise or lower intraocular pressure, especially when uveitis affects drainage structures, so this measurement helps guide treatment.Amsler grid test (manual test)
The patient looks at a small grid of straight lines and reports any missing or wavy areas. Distortion or blank spots on the grid can show central retinal damage from chorioretinitis, even when changes are subtle.Visual field testing (perimetry) (manual test)
This test measures side vision by asking the patient to press a button when lights appear in different areas. Areas where no lights are seen correspond to blind spots or field defects caused by chorioretinal lesions or optic nerve involvement.
Laboratory and pathological tests
Complete blood count and inflammatory markers (lab test)
A blood sample measures white cells, red cells, platelets, and markers like ESR or CRP. High or low counts, or raised inflammatory markers, can point toward infection, systemic inflammation, or bone-marrow problems related to chorioretinitis.Toxoplasma serology (lab test)
Blood tests for Toxoplasma gondii antibodies (IgG and IgM) help detect current or past toxoplasma infection. A pattern of positive IgG with clinical signs supports toxoplasmic chorioretinitis, whereas negative tests make this cause less likely.Viral serology (lab test)
Tests for CMV, HSV, VZV, and HIV look for antibodies or viral load. These results help link chorioretinitis to specific viral infections and guide antiviral treatment and immune system evaluation.Syphilis testing (lab test)
Blood tests such as VDRL/RPR and treponemal tests (TPHA/FTA-ABS) check for syphilis. Because syphilitic chorioretinitis can mimic many other patterns, guidelines recommend syphilis screening in nearly all unexplained posterior uveitis cases.Tuberculosis testing (lab test)
Skin tests (tuberculin skin test) or blood tests (IGRA) plus chest imaging look for TB infection. Positive results, especially with compatible eye findings and risk factors, raise suspicion for tuberculous chorioretinitis and may lead to anti-TB therapy.Autoimmune and inflammatory markers (lab test)
Tests like ANA, ANCA, ACE levels, HLA-B27, and others look for autoimmune diseases such as sarcoidosis, Behçet’s disease, or systemic vasculitis. Finding these markers supports a non-infectious inflammatory cause of chorioretinitis.
Electrodiagnostic tests
Electroretinography (ERG) (electrodiagnostic test)
ERG measures the electrical responses of retinal cells to light flashes. In chorioretinitis, ERG may show reduced or altered signals in affected areas, helping to assess how much of the retina is damaged or dysfunctional.Visual evoked potentials (VEP) (electrodiagnostic test)
VEP recording measures the brain’s electrical response to visual stimuli. It can show slowed or decreased signals along the visual pathway when the retina or optic nerve is damaged by inflammation or its complications.
Imaging tests
Optical coherence tomography (OCT) (imaging test)
OCT uses light waves to take cross-section pictures of the retina and choroid, like an “optical ultrasound.” In chorioretinitis, OCT can show swelling, fluid, tissue loss, or scarring, and it helps monitor response to treatment over time.Fluorescein angiography (FA) (imaging test)
A fluorescent dye is injected into a vein, and rapid photos are taken as it flows through the retinal blood vessels. FA reveals leaking vessels, blocked areas, and new abnormal vessels that may occur in chorioretinitis, guiding diagnosis and laser or drug therapy when needed.Ocular ultrasound (B-scan) (imaging test)
When the view of the retina is blocked by dense cataract or severe vitreous haze, ultrasound is used to “see through” these opacities. It can detect retinal detachment, large inflammatory masses, or other structural changes related to chorioretinitis.
Non-Pharmacological Treatments
1. Eye rest and light protection
Resting the eyes in a dark or dim room can reduce discomfort when chorioretinitis makes light very painful. Simple steps like closing the eyes, using blackout curtains, or wearing a hat indoors lower light entering the eye. This does not cure the disease but reduces strain while medicines do the real work.
2. Sunglasses and UV-blocking lenses
High-quality sunglasses that block ultraviolet (UV) and bright visible light protect the already inflamed retina from extra light stress. Polarized lenses may also reduce glare, which many patients find very uncomfortable. Eye doctors often recommend sunglasses outdoors for most uveitis and chorioretinitis patients as part of daily eye protection.
3. Avoiding intense screens and near work during flares
Long periods on phones, computers, or reading can worsen eye pain and blur when the back of the eye is inflamed. Short breaks every 20 minutes, larger font, and voice-to-text tools reduce the workload on the retina. This helps symptoms while the underlying infection or inflammation is being treated.
4. Position and activity modification
During active disease, doctors may advise avoiding heavy lifting, high-impact exercise, or activities that risk eye trauma. Gentle walking and light household tasks are usually safe. Reducing sudden pressure changes may help keep fragile inflamed tissues from additional stress.
5. Strict control of systemic diseases
For chorioretinitis linked to autoimmune disease (like non-infectious posterior uveitis), keeping the whole-body disease quiet is essential. Taking systemic treatments on schedule, controlling blood sugar in diabetes, and managing hypertension all support eye healing. Poor systemic control often means more eye flares and worse vision.
6. Smoking cessation
Smoking increases inflammation and damages blood vessels, including those that feed the retina and choroid. Stopping smoking improves circulation, reduces oxidative stress, and may help medicines work better. Eye specialists often strongly advise quitting to protect long-term vision in all inflammatory eye diseases.
7. Healthy sleep routine
Good sleep supports the immune system and helps the body repair tissues. Regular bedtimes, dark rooms, and avoiding caffeine late in the day can improve sleep quality. Better sleep may help the body handle infections and lower overall inflammation, indirectly supporting chorioretinitis recovery.
8. Stress-reduction techniques
Chronic stress pushes the body into a “fight or flight” state and can disturb immune balance. Simple practices like deep breathing, short walks, gentle yoga, or mindfulness apps may help reduce stress and improve coping with a long eye illness. Lower stress can support immune control and treatment adherence.
9. Low-vision aids
Some people with chorioretinitis lose central or peripheral vision even after the inflammation is controlled. Low-vision rehabilitation, magnifiers, high-contrast reading materials, large-print devices, and apps that read text aloud can help people function better at home and work, even with stable scars.
10. Protective eyewear
When the retina is compromised, any extra trauma to the eye is more dangerous. Safety glasses during sports, work with tools, or gardening help prevent accidents. This is especially important if only one eye sees well, or if the other eye already has scarring from chorioretinitis.
11. Avoiding contact lenses during active inflammation
During active chorioretinitis or uveitis, and especially if topical steroids are used, many doctors tell patients to stop wearing contact lenses. This reduces the risk of corneal infection and irritation and makes it easier to use eye drops correctly. Contacts are usually restarted only when the eye is quiet.
12. Strict infection-control habits
Hand-washing, safe food handling (to reduce Toxoplasma infection), and safer sex practices (for syphilis, HIV) all reduce infection risk. Pregnant people and those with weak immune systems should avoid undercooked meat and unwashed vegetables to limit toxoplasmosis, a major cause of chorioretinitis worldwide.
13. Vaccination as advised
Some causes of posterior uveitis and chorioretinitis happen more often when immunity is very low. Staying updated on routine vaccines (such as for measles or varicella if appropriate) and any vaccines recommended for immunosuppressed patients helps reduce the chance of serious infections that can involve the eye.
14. Blood sugar and blood pressure control
High blood sugar and high blood pressure damage small vessels in the retina and choroid over time. Tight control, guided by a primary-care or diabetes doctor, protects the micro-circulation and may improve outcomes when chorioretinitis occurs on top of diabetic or hypertensive eye disease.
15. Regular follow-up visits and imaging
Even when symptoms feel better, inflammation at the back of the eye can still be active. Regular eye exams, optical coherence tomography (OCT) scans, and retinal photos allow doctors to catch new lesions early and adjust treatment before vision is lost.
16. Adherence counseling
Chorioretinitis treatment can be complex, with many pills and eye drops. Education, written schedules, alarms, and family support help patients take medicines correctly. Good adherence is one of the strongest non-drug tools to protect long-term vision.
17. Dietitian-guided nutrition
Seeing a dietitian can help patients build a menu rich in eye-supporting nutrients (like lutein, zeaxanthin, omega-3s, vitamins A, C, and E) while respecting other health needs like diabetes or kidney disease. A balanced diet supports immunity and tissue repair across the body.
18. Education about warning signs
Teaching patients to recognize new floaters, flashes of light, dark curtains, severe pain, or sudden blur helps them return to care quickly. Fast action when these symptoms start can make the difference between reversible inflammation and permanent retinal damage.
19. Psychological and social support
Living with a chronic or sight-threatening eye condition is emotionally heavy. Counseling, support groups, or talking with others who have uveitis can reduce anxiety and depression. Better mental health often improves treatment adherence and overall quality of life.
20. Safe physical activity plan
Many patients can continue gentle exercise like walking, stretching, or light yoga. Movement supports heart and brain health and may help reduce systemic inflammation. Plans should be adapted so there is no risk of falls or head trauma when vision is reduced.
Drug Treatments for Chorioretinitis
Important: All doses below are general information from drug-label or guideline summaries. Only your doctor can choose the right drug, dose, and duration for you. Never start or stop any of these on your own.
1. Pyrimethamine (Daraprim)
Pyrimethamine is an antiparasitic medicine used as a cornerstone drug against toxoplasmosis, a leading cause of infectious chorioretinitis. It blocks folic-acid pathways in the parasite, slowing its growth. Labels describe dosing in combination with other drugs and always with folinic acid to protect the bone marrow. Common side effects include low blood counts and gastrointestinal upset.
2. Sulfadiazine
Sulfadiazine is a sulfonamide antibiotic that works together with pyrimethamine. The combo attacks the toxoplasma parasite at two different metabolic steps, making treatment more effective. Typical regimens use a loading dose followed by divided daily doses, but details vary by body weight and kidney function. Rash, kidney crystals, and allergy are important risks, so patients need close monitoring.
3. Trimethoprim-sulfamethoxazole (TMP-SMX)
TMP-SMX combines two antibiotics in one tablet and is often used as an alternative regimen for ocular toxoplasmosis. It disrupts folate metabolism in the parasite and bacteria. Doctors may choose it when classic pyrimethamine regimens are not available or not tolerated. Side effects include allergy, rash, and effects on kidney and bone marrow, so lab tests are needed.
4. Clindamycin
Clindamycin is another antibiotic used in some chorioretinitis regimens, often with pyrimethamine or TMP-SMX. It blocks protein synthesis in certain bacteria and protozoa. For ocular toxoplasmosis, it is usually given orally and sometimes combined with steroids. Diarrhea and a serious colon infection called C. difficile–associated colitis are important possible side effects.
5. Azithromycin
Azithromycin is a macrolide antibiotic sometimes used as a partner or alternative in toxoplasmosis treatment. It interferes with protein synthesis in bacteria and some parasites. It has a long half-life, which allows once-daily dosing. Doctors watch for gastrointestinal upset and, in some patients, effects on heart rhythm (QT prolongation) seen in label warnings.
6. Oral prednisone
Prednisone is a systemic corticosteroid widely used to reduce inflammation in chorioretinitis. It dampens immune activity, lowering swelling and damage in the retina and choroid. It is never started before adequate antimicrobial therapy in infectious cases, because steroids alone can worsen infection. Side effects include weight gain, mood changes, high blood sugar, and bone loss, especially with long-term use.
7. Prednisolone acetate eye drops
This corticosteroid eye drop delivers high steroid levels to the eye surface and to some inner tissues. It is often used with systemic treatment for anterior or intermediate uveitis that accompanies chorioretinitis. Drops must be tapered slowly. Risks include raised eye pressure and cataract with prolonged or improper use, so intraocular pressure is checked regularly.
8. Intravitreal dexamethasone implant
Dexamethasone implants (such as DEX implants) are tiny devices placed inside the eye to slowly release steroid into the vitreous. They are mainly used for non-infectious posterior uveitis involving the macula and can reduce swelling and improve vision. Risks include elevated eye pressure and cataract, so they are reserved for carefully chosen patients.
9. Valganciclovir (Valcyte)
Valganciclovir is an antiviral drug used for CMV retinitis, a serious viral chorioretinitis in people with weak immune systems (such as advanced HIV). In the body, it converts to ganciclovir, which blocks viral DNA replication. Labels describe an induction dose followed by maintenance, with close monitoring of kidney function and blood counts because it can cause severe bone-marrow suppression.
10. Ganciclovir (IV or intraocular)
Ganciclovir can be given intravenously or injected into the eye for CMV retinitis. It directly interferes with viral DNA synthesis. It is often used together with oral valganciclovir in severe cases. Like valganciclovir, it can cause low white cells, anemia, and low platelets, so regular blood tests are essential.
11. Foscarnet
Foscarnet is another antiviral used when CMV is resistant to ganciclovir or when patients cannot tolerate it. It directly blocks viral DNA polymerase. It is given IV and requires careful kidney monitoring and fluid management because it can damage the kidneys and disturb minerals like calcium and magnesium.
12. Acyclovir / Valacyclovir
These antivirals are used when chorioretinitis is caused by herpes simplex or varicella-zoster viruses. They mimic building blocks of DNA and stop viral replication. Oral or IV regimens are chosen based on severity and immune status. Side effects include kidney effects at high doses and, rarely, neurological symptoms, especially in patients with kidney problems.
13. Methotrexate
Methotrexate is an immunosuppressant used as a “steroid-sparing” agent in chronic non-infectious posterior uveitis. It reduces abnormal immune activity that drives inflammation. Low weekly doses are common, with folic acid to reduce toxicity. Monitoring for liver, lung, and bone-marrow side effects is essential.
14. Azathioprine
Azathioprine is another systemic immunosuppressant used when steroid doses must be lowered. It reduces lymphocyte activity and helps maintain quiet eyes in autoimmune uveitis. Doctors monitor blood counts and liver tests and check for infection risk and rare serious complications like lymphoma in long-term use.
15. Mycophenolate mofetil
Mycophenolate is often chosen because it is generally well tolerated and effective in controlling chronic posterior uveitis. It blocks purine synthesis in lymphocytes, reducing abnormal immune attacks on the retina and choroid. Regular lab checks watch for low white cells, liver issues, and gastrointestinal side effects like diarrhea.
16. Cyclosporine
Cyclosporine inhibits T-cell activation and is used in difficult autoimmune uveitis. It can be combined with steroids or other agents when single drugs are not enough. Doctors carefully monitor blood pressure and kidney function, since kidney damage and hypertension are important dose-related risks.
17. Adalimumab
Adalimumab is a biologic anti-TNF antibody approved in many regions for non-infectious intermediate, posterior, and panuveitis. It blocks TNF-alpha, a key inflammatory signal. It is given by subcutaneous injection at regular intervals. Screening for TB and hepatitis is essential before starting, and patients must be monitored for infection and rare serious side effects.
18. Infliximab
Infliximab is another anti-TNF biologic given by IV infusion. It is used off-label in severe uveitis, including some chorioretinitis cases, especially in children or adults with systemic autoimmune disease. It works similarly to adalimumab but requires infusion centers and close monitoring during and after infusions for infusion reactions and infections.
19. Antibiotics for TB-related uveitis
When chorioretinitis is related to tuberculosis, multi-drug anti-TB therapy (for example isoniazid, rifampin, ethambutol, and pyrazinamide as per national guidelines) is used. These drugs kill Mycobacterium tuberculosis in the body and eye. Doses and duration follow TB protocols, and eye-specific treatment is added on top. Liver function and vision (for ethambutol) are carefully monitored.
20. Penicillin or ceftriaxone for syphilitic uveitis
If syphilis is the cause, high-dose IV penicillin G or ceftriaxone is used according to neurosyphilis protocols. Clearing the infection is crucial to stop eye damage. Side effects can include allergy, diarrhea, and local infusion reactions. Care is often coordinated between infectious-disease and eye specialists.
Dietary Molecular Supplements
Supplements do not replace medical treatment for chorioretinitis, but some nutrients support retinal health and general immunity. Always ask your doctor before starting any supplement.
1. Lutein
Lutein is a yellow plant pigment that collects in the macula at the back of the eye. It acts as an antioxidant and a natural filter for blue light, which may help protect retinal cells from damage. Many studies suggest lutein can support macular health and may lower risk of chronic retinal disease when taken as part of a balanced diet or supplement.
2. Zeaxanthin
Zeaxanthin is another carotenoid that concentrates in the retina, especially the fovea, where detailed vision happens. It works with lutein to neutralize free radicals and filter harmful light. Regular intake through leafy greens or supplements can raise macular pigment levels, which may help long-term retinal protection.
3. Omega-3 fatty acids (EPA/DHA)
Omega-3s are healthy fats found in oily fish and some plant oils. DHA is a structural part of retinal cell membranes, and EPA helps control inflammation. Studies show omega-3s can improve dry-eye symptoms and may support overall retinal health, though they are not a direct treatment for chorioretinitis. Typical supplement doses are in the gram range and must be chosen with medical advice.
4. Vitamin A (retinol or beta-carotene)
Vitamin A is essential for the visual cycle and night vision. Adequate intake helps keep the retina and surface of the eye healthy. However, high doses can be toxic to the liver and harmful in pregnancy, so any vitamin A supplement should be strictly supervised, especially if other drugs are being used. A varied diet with colorful vegetables is often safer than high-dose pills.
5. Vitamin C
Vitamin C is a water-soluble antioxidant that helps regenerate other antioxidants and supports collagen in blood vessels. In the eye, it may help reduce oxidative stress related to chronic inflammation. Most people can meet needs through fruits and vegetables; supplements are usually modest doses unless a doctor suggests otherwise.
6. Vitamin E
Vitamin E is a fat-soluble antioxidant that lives in cell membranes, including those in the retina. It works with vitamin C and carotenoids to protect against oxidative damage. High-dose vitamin E supplements are not safe for everyone (for example, some heart or bleeding-risk patients), so balanced dietary intake and medical guidance are important.
7. Zinc
Zinc is a trace mineral needed for many enzymes in the retina and immune system. Trials in macular degeneration show certain zinc-containing combinations can slow disease in some patients. Too much zinc, however, can upset copper balance and cause other problems, so doses must stay within recommended ranges.
8. Selenium
Selenium is part of antioxidant enzymes like glutathione peroxidase, which help control oxidative stress. Adequate selenium supports immunity and may indirectly help tissues cope with chronic inflammation. Because the safe dose range is narrow, supplements should not exceed medical advice, especially in regions with selenium-rich soil.
9. Probiotics
Probiotics are “good” bacteria taken as capsules or fermented foods. They may help balance the gut microbiome and modulate the immune system. In some autoimmune and inflammatory conditions, healthier gut flora may help reduce systemic inflammation, which could indirectly benefit eye inflammation, though evidence is still emerging.
10. Curcumin (from turmeric)
Curcumin is a plant compound with anti-inflammatory and antioxidant properties in laboratory and early clinical studies. Some formulations are designed for better absorption. It may modestly reduce markers of inflammation, but it can interact with blood thinners and other drugs. For chorioretinitis, it should be viewed only as a supportive dietary component, never as primary therapy.
Immune-Boosting / Regenerative / Stem-Cell-Related Drugs
These options are not standard routine treatments for typical chorioretinitis. They are used only in selected patients or research settings.
1. Intravenous immunoglobulin (IVIG)
IVIG is pooled antibodies from donors, given as an infusion. It can modulate the immune system in certain autoimmune or inflammatory diseases. In rare, severe uveitis related to systemic immune disorders, IVIG may be used to calm inflammation when other treatments fail. It is expensive and requires hospital monitoring for infusion reactions and kidney stress.
2. Hematopoietic stem cell transplantation
Stem cell transplant is mainly used for blood cancers and some life-threatening autoimmune diseases. By replacing a damaged immune system with a new one, it can indirectly affect eye inflammation. For chorioretinitis, it is not a primary therapy but may be relevant when the underlying systemic disease is treated this way. Risks are very high, so it is reserved for selected cases.
3. Experimental mesenchymal stem cell therapy
In research studies, mesenchymal stem cells are being explored for their ability to release anti-inflammatory and protective factors in various eye diseases. These trials are strictly controlled, and long-term safety and effectiveness are still unknown. Patients should only consider such treatment within ethics-approved clinical trials, never in unregulated settings.
4. Biologic immune-modulators as “immune reset”
Biologics like anti-TNF agents (adalimumab, infliximab) or other targeted antibodies can, in a sense, “reset” over-active immune pathways driving posterior uveitis and chorioretinitis. They are not stem cells but are powerful tools to reshape immune responses. Close monitoring for infections and rare serious adverse events is essential.
5. Colony-stimulating factors (e.g., G-CSF) in severe immunosuppression
When patients need strong immunosuppression and develop very low white blood cell counts, drugs like G-CSF may be used to help the bone marrow recover. This does not directly treat chorioretinitis but allows continuation of crucial immunosuppressive or antimicrobial therapy with less risk of life-threatening infection.
6. Neuroprotective and gene-therapy approaches (research)
Gene therapies and neuroprotective agents are being studied for inherited retinal diseases and some acquired retinal damage. They aim to repair or protect retinal cells. At present they are not standard treatment for chorioretinitis but may be relevant in the future, especially for patients with extensive retinal damage after inflammation.
Surgeries for Chorioretinitis
1. Pars plana vitrectomy
Vitrectomy is a surgery where the gel (vitreous) inside the eye is removed and replaced with clear fluid or gas. It is used when dense vitreous floaters, hemorrhage, or scar tissue block the view or pull on the retina. In chorioretinitis, vitrectomy can clear the visual axis, allow better drug delivery, and help repair complications like retinal detachment.
2. Retinal detachment repair
Severe inflammation can lead to tears and detachments of the retina. Surgeons may use scleral buckling, vitrectomy, laser, and tamponade gases or oils to reattach the retina. The goal is to restore anatomical position and preserve any remaining vision. Outcomes depend on how long the detachment has been present and how damaged the retina already is.
3. Laser photocoagulation
Laser treatment can seal small retinal tears or surround areas of active or past lesions to reduce the risk of new breaks. In some infectious lesions near critical structures, laser may be used carefully to limit spread of damage. It is done under local anesthesia, and patients may see flashes of light during the procedure.
4. Intravitreal injection procedures
Although injections are not “surgery” in the traditional sense, they are sterile invasive procedures. Anti-infective or steroid medicines are injected directly into the vitreous cavity to reach high local levels. This can be life-saving for the eye in rapidly progressive infections like CMV retinitis. Patients feel pressure but usually little pain with proper anesthesia.
5. Cataract surgery after chronic inflammation
Long-term steroid use and chronic uveitis often cause cataracts. Once inflammation has been quiet for a safe period, cataract surgery can restore clarity and improve vision. Surgeons choose lens types and techniques carefully to reduce the risk of post-operative inflammation and macular swelling.
Preventions
Cook meat thoroughly and wash vegetables well to lower the risk of toxoplasmosis, a key infectious cause of chorioretinitis.
Avoid unpasteurized milk and unsafe water that may carry parasites or bacteria linked to eye infections.
Practice safer sex and regular STI testing to reduce the risk of syphilis and HIV, which can lead to serious posterior uveitis.
Keep vaccinations up to date (as advised by your doctor) to prevent systemic infections that can involve the eye.
Control chronic diseases like diabetes and hypertension to protect the retinal blood supply and reduce complications.
Do not smoke; quitting protects retinal circulation and reduces overall inflammation.
Use protective eyewear to avoid trauma that can complicate or trigger eye inflammation.
Have regular comprehensive eye exams if you have autoimmune disease, HIV, or other high-risk conditions.
Avoid self-medicating with steroid eye drops without a prescription, because this can worsen hidden infections.
Follow all prescribed treatments exactly and keep follow-up visits so doctors can adjust therapy before serious damage occurs.
When to See a Doctor Urgently
You should seek immediate eye care (emergency or same day) if you notice any of the following:
Sudden or rapidly worsening blurred vision in one or both eyes.
New floaters, dark spots, or a “curtain” or “shadow” coming over your vision.
Severe eye pain, especially with redness and light sensitivity.
Flashes of light, distorted central vision, or sudden loss of side vision.
Any sudden change in vision if you are pregnant, have HIV, autoimmune disease, or are on strong steroids or immunosuppressants.
If you already have chorioretinitis, missing appointments or stopping medicines without advice is dangerous. Contact your eye specialist promptly if side effects, new symptoms, or pregnancy occur.
What to Eat and What to Avoid
Eat: Dark leafy greens (spinach, kale) rich in lutein and zeaxanthin. Avoid: Very salty processed foods that worsen blood pressure.
Eat: Fatty fish (salmon, sardines) with omega-3s several times per week, if allowed. Avoid: Deep-fried fast foods high in trans fats.
Eat: Colorful fruits and vegetables (carrots, peppers, berries) packed with vitamins A and C. Avoid: Sugary drinks that spike blood sugar.
Eat: Nuts and seeds (especially pistachios and walnuts) that provide healthy fats and eye-supporting nutrients. Avoid: Large amounts of alcohol, which can harm liver and overall health.
Eat: Whole grains instead of refined white flour products to help stable blood sugar and energy. Avoid: Very high glycemic snacks that worsen diabetes control.
Eat: Adequate protein (eggs, beans, lean meats) to support tissue repair. Avoid: Crash diets or extreme fasting that weaken overall health.
Eat: Hydrating fluids like water and herbal teas. Avoid: Excess energy drinks or heavy caffeine, which may disturb sleep and recovery.
Eat: Fermented foods (yogurt with live cultures, kefir) if tolerated, to support gut microbiome. Avoid: Overuse of over-the-counter herbal products without checking for drug interactions.
Eat: Home-cooked meals using safe food handling to reduce infection risk. Avoid: Undercooked meat and unwashed raw produce, which can carry Toxoplasma and other pathogens.
Eat: Balanced meals as recommended by your doctor or dietitian for your diseases. Avoid: Any supplement or “eye cure” marketed without solid medical evidence. Always discuss changes with your care team.
Frequently Asked Questions
1. Is chorioretinitis always caused by infection?
No. Many cases are infectious (toxoplasmosis, CMV, TB, syphilis), but others are autoimmune and part of non-infectious posterior uveitis. Treatment is completely different depending on the cause, so proper testing is essential.
2. Can chorioretinitis make me blind?
Yes, if untreated or if treatment is delayed, scarring of the macula or complications like retinal detachment can cause permanent vision loss. Early diagnosis, correct drugs, and regular follow-up greatly lower this risk.
3. How long does treatment usually last?
Infectious chorioretinitis can need weeks to months of therapy; autoimmune cases may need long-term or even lifelong control with immunosuppressants. Your doctor adjusts duration based on how your retina looks, not just how you feel.
4. Why can’t I take steroids alone when my eye is inflamed?
Steroids calm inflammation but also suppress the immune system. In untreated infection, steroids alone can let germs grow faster, worsening the disease. That is why eye doctors treat the infection first or at the same time, then add steroids.
5. Will I need injections into my eye?
Some patients do. Intravitreal injections deliver very high drug levels directly to the retina for infections like CMV retinitis or for strong local steroids in non-infectious uveitis. Your doctor will weigh benefits versus risks like infection or pressure rise.
6. Are biologic drugs safe for eye inflammation?
Biologics like adalimumab are effective for many people with non-infectious uveitis, but they increase infection risk and have other possible side effects. Screening and regular monitoring are required. For many, they allow lower steroid doses and better long-term control.
7. Can diet alone cure chorioretinitis?
No. Diet and supplements can support overall eye and immune health but cannot clear infections or replace immunosuppressive therapy. Relying on diet alone for an active chorioretinitis episode is dangerous.
8. Is it safe to use herbal eye drops or home remedies?
Unregulated eye drops or homemade mixtures can introduce germs, irritate the surface, or interact with medicines. Always check with your ophthalmologist before using any non-prescribed eye product.
9. Can I continue working or studying?
Many people can, with adjustments like larger print, screen breaks, and good lighting. During severe flares or after surgery, you may need time off. Your doctor and employer or school can help you plan accommodations.
10. Will I get chorioretinitis again after it heals?
Some causes, like toxoplasmosis, can flare again from old scars; autoimmune forms can also relapse. Regular monitoring, preventive drugs in high-risk people, and quick treatment of new symptoms help reduce damage from recurrences.
11. Is pregnancy safe if I have a history of chorioretinitis?
Many people with controlled disease have healthy pregnancies, but active infection or certain drugs can be dangerous to the baby. Planning pregnancy with your ophthalmologist and obstetrician is very important so medicines can be adjusted safely.
12. Can children get chorioretinitis?
Yes. Congenital infections like toxoplasmosis or CMV and childhood autoimmune diseases can cause chorioretinitis. Children need specialized pediatric eye and infectious-disease care and long-term follow-up to watch for growth-related changes.
13. Are regular sunglasses enough, or do I need special medical ones?
For most patients, good-quality sunglasses that block 100% UVA/UVB and reduce glare are enough. Wraparound designs may be more comfortable. Your doctor may recommend specific tints if you have special visual needs.
14. How often should I see my eye doctor after a flare?
In the active phase, visits may be weekly or even more frequent. When stable, visits can be spaced out to months. People on long-term immunosuppressants or with high-risk conditions need regular, lifelong eye checks.
15. What is the single most important thing I can do to protect my vision?
The most important step is never ignoring symptoms or stopping medicines on your own. Work closely with your eye specialist, keep all follow-ups, and ask questions whenever you are unsure. Early, continuous, team-based care gives the best chance to save vision.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: January 14, 2026.
