We were very interested to read the correspondence from Paul Steptoe et al. in response to our recent report of dark without pressure (DWP) lesions in children [1]. We thank them for their interesting comments. Despite a thorough literature search we failed to identify their first paper [2] on the association of DWP with chorioretinal scarring occurring in survivors of Ebola fever and their second paper [3] was published after our paper was submitted. Their observations deal with adults rather than children and highlight the geographical association of Ebola-related chorioretinal inflammation with patches of DWP and the authors suggest that the Ebola-related inflammation may stimulate DWP patches to form. This is an interesting hypothesis but currently the evidence for causation is lacking; it will however be interesting to see whether DWP is reported in association with other forms or retinal inflammation. In the majority of patients DWP will be an incidental retinal finding with no obvious precipitating factors.

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