Bilateral congenital trigemino-abducens synkinesis.

occult outer retinopathy viral introduction in the retina may occur at the optic nerve margin and ora serrata because of the absence of surrounding neuroepithelium at these sites. The initial manifestation of transient discrete peripapillary outer retina or retinal pigment epithelium involvement centered around the optic nerve in our patient would be consistent with such a hypothesis. The funduscopic appearance subsequently evolved into more typical MEWDS findings, including deep retinal white dots surrounding the paramacular area with foveal sparing, blurring of the disc margin, and vascular involvement at angiography. The patient’s subjective complaints of photopsia and temporal scotoma and the blind spot enlargement at visual field testing are all consistent with the diagnosis of MEWDS. Because of their transient nature, these peripapillary findings may be more common in MEWDS than previously appreciated.