A 1 month-old girl is brought to the clinic for a routine evaluation. The patient was delivered via a
cesarean at 38-weeks gestational age due to arrested
labor. The mother immigrated from Zambia ten months ago and received minimal
prenatal care. During the first trimester of pregnancy, she developed an
upper respiratory infection and self-limited joint pain affecting the
wrists, knees, and ankles. Family history is notable for
retinitis pigmentosa. The patient’s weight is at the 20
th percentile, and head circumference is at the 50
th percentile. Vitals are within normal limits. She does not move her
head in response to sounds. Facial features appear normal. Physical examination is notable for
petechiae and
purpura over the arms, trunk, and legs. A cardiac examination reveals a continuous
murmur heard in the left infraclavicular area. Abdominal examination is notable for hepatosplenomegaly. Which of the following findings is most likely present on this patient’s ophthalmologic examination?
