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The first portion of this chapter discusses inflammatory and infectious disorders that affect the posterior segment of the eye. Some of the disorders that are discussed are much more common in children than in adults (e.g., pars planitis). Although others are more common in adults, the ability to recognize their appearance is important because they can occur in pediatric patients (e.g., the presumed ocular histoplasmosis syndrome). In the last portion of the chapter, nutritional and toxic disorders of the retina are presented. Table 11-1 lists various infectious, inflammatory, toxic, and nutritional disorders of the retina and vitreous in the approximate order of their prevalence in children. Disorders that occur primarily in children are marked with a “c”; disorders that occur primarily in adults are marked with an “a”; conditions that occur in both groups are marked “a,c.”

The term myopia refers to a spectrum of ocular disorders in which the far point of the eye is closer to the retina than infinity. The resultant disparity between good vision at “near” (i.e., at a distance from the eye that is at or within the far point plane)and “distance” (any point beyond the far point plane for that particular eye) may be caused by a number of factors. Because most cases of myopia have a benign etiology and course, the importance of this disorder as a predisposing factor for serious retinal pathology is often overlooked.

Chapter 30 in this volume stresses that not all diseases that look alike have the same etiology. Very different causes may produce identical clinical pictures, and disorders with similar ophthalmoscopic findings may have widely disparate clinical courses and modes of inheritance. Traditionally, eye disease nomenclature has been based upon underlying etiologies and on which structures in the eye harbor the initial or inciting defect. However, the reality of clinical practice is that when patients present to an ophthalmologist, one of the most important clues the physician has about the disorder is the appearance of the fundus. Therefore, in this chapter, many of the retinal disorders that have been discussed earlier in the retina section are briefly reviewed from two new perspectives: ophthalmoscopic appearance and systemic associations.