Live Adult Loa-Loa in the Anterior Chamber of a Nigerian female

Background: Live adult loa loa is not usually found in the anterior chamber of the eye. Where this occurs the diagnosis may be missed because of its rare occurrence. As such there has to be a high index of suspicion to be able to make a diagnosis of ocular loaiasis. Aim: To report a case of live adult loa-loa in the anterior chamber of the left eye of a 23-year-old Nigerian female and discuss the management and visual outcome following treatment. Setting: Department of Ophthalmology; University of Port-Harcourt Teaching Hospital; Port Harcourt. Case Report: A case report of live adult loa-loa in the anterior chamber of a 23-year-old Nigerian female is here presented. In May 2006; a 23 year old female presented at the Eye Clinic with a 3-week history of pain; itching and redness and a one-week history of poor vision in the left eye. Her presenting visual acuity was hand movement on the left and 6/5 on the right. She had a steamy cornea with a sluggishly reactive pupil and an elevated left intra-ocular pressure. An initial diagnosis of pan-uveitis with secondary glaucoma was made and patient commenced on treatment. Patient came back two days and a live adult loa-loa was extracted from the anterior chamber of the left eye. Patient's vision however remained at Counting Fingers despite aggressive treatment with topical and systemic steroids; and systemic diethylcabamazine. Conclusion: Ophthalmologist working in this environment should entertain loaiasis as a differential diagnosis of uveitis since it could masquerade as one and also know the current mode of treatment

Guidelines for rapid assessment of LOA LOA

RAPLOA is a rapid assessment procedure for Loa loa that uses a simple questionnaire on the history of eye worm to predict whether or not loiasis is present in a community at a high level of endemicity. In highly endemic communities; there is a risk of severe adverse reactions to the drug ivermectin following its use as treatment for ether onchocerciasis or lymphatic filariasis. RAPLOA will facilitate the planning of ivermectin distribution programmes by predicting in which communities ivermectin treatment for onchocerciasis can be safely implemented.This document describes the APLOA method; and provides guidelines on how to implement RAPLOA and how to interpret the results. The guidelines are intended for planners and implementers of ivermectin distribution programmes in Africa