Post-natal rubella (German measles) is a mild illness, occasionally complicated by arthritis or encephalitis. In contrast, in utero infection can have devastating effects, collectively known as Congenital Rubella Syndrome (CRS). Though the introduction of MMR vaccination programs has reduced the incidence of notifications and deaths from rubella by 96% to 0.4 per 100,000 births, CRS persists in patients who predate the commencement of these programs (c. 1969), as well as those not immunized and, rarely, in re-infection of the immune.

The stigmata of CRS are widespread, encompassing neural, ocular and systemic development, and manifest as a spectrum of involvement. In this report, we present a case of CRS, manifesting with both auditory and visual loss, including changes in VA and visual fields. These losses were the result of bilateral pigment retinopathy and cataract, though the patient is also at risk of developing glaucoma. Management for ocular CRS is similar to that for age-related macular degeneration, including counselling, regular monitoring and the provision of low vision aids, if required.

OPTOMETRY -ST LOUIS- VOL 73; PART 7; 2002; pp. 418-424

Harrison S Weisinger* MScOptom PhD
Konrad Pesudovs† BScOptom PhD FVCO FAAO FCLSA

* Department of Food Science, RMIT University, Melbourne
† Department of Ophthalmology, Flinders Medical Centre and Flinders University of South Australia