Vision loss after i.v. Heroin Abuse

A 21 y/o female with a history of i.v. heroin abuse and bipolar disorder presented with painless vision loss of the left eye over 4 weeks. Examination revealed count-fingers vision in the affected left eye with trace cell in the anterior chamber. Fundus of the left eye shows optic nerve head edema and vitreous debris. Clinical examination of the right eye was unremarkable. Dx? treatment?

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intravenous (i.v.) heroin use-associated endogenous endophthalmitis Toxic optic neuropathy Management:- vitrectomy followed by intravitreal voriconazole and 3 weeks of oral voriconazole.
Heroin abuse induced optic neuritis and macular exudates

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