ABSTRACT
A live intraocular nematode was identified from a 37 year-old man presented with iritis, pain, redness, lacrimation, swelling, vision loss and intermittent blindness during many hours per day of the left eye. By using slit lamp examination, a worm was removed from iris in an ophthalmology outpatient department setting and sent to the Medical Microbiology Laboratory, Institut Pasteur du Cambodge. Gnathostoma spinigerum was identified, based on its typical morphology via microscopic examination. Based on our diagnosis, the patient was treated by oral albendazole and responded well to this therapy.
Subject(s)
Eye Infections, Parasitic/epidemiology , Gnathostomiasis/epidemiology , Iritis/epidemiology , Adult , Agricultural Workers' Diseases/drug therapy , Agricultural Workers' Diseases/parasitology , Albendazole/therapeutic use , Animals , Anthelmintics/therapeutic use , Cambodia/epidemiology , Eye Infections, Parasitic/drug therapy , Eye Infections, Parasitic/parasitology , Gnathostoma/growth & development , Gnathostoma/isolation & purification , Gnathostoma/ultrastructure , Gnathostomiasis/drug therapy , Humans , Iris/parasitology , Iritis/drug therapy , Iritis/parasitology , Larva , Male , Paracentesis , Vision Disorders/etiology , Vision Disorders/parasitologySubject(s)
Corneal Injuries , Eye Foreign Bodies/diagnosis , Eye Injuries, Penetrating/diagnosis , Iritis/diagnosis , Lepidoptera , Ocular Hypertension/diagnosis , Tomography, Optical Coherence , Acute Disease , Animals , Anti-Bacterial Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Child , Drug Therapy, Combination , Eye Foreign Bodies/drug therapy , Eye Foreign Bodies/parasitology , Eye Injuries, Penetrating/drug therapy , Eye Injuries, Penetrating/parasitology , Female , Glucocorticoids/therapeutic use , Humans , Iritis/drug therapy , Iritis/parasitology , Mydriatics/therapeutic use , Ocular Hypertension/drug therapy , Ocular Hypertension/parasitology , Visual AcuityABSTRACT
PURPOSE: There are thousands of parasitic nematode species that have been identified. Many have been documented to invade the eye and periorbital tissues. Whether adult or larvae, alive or dead, they can result in a wide range of ocular and systemic manifestations. Classification of the nematode can be helpful in the treatment planning for these patients. CASE REPORT: A 60-year-old Hispanic male presented without complaints. During routine examination, the presence of peripheral anterior synechiae, posterior synechiae, and focal cataract were linked to an immobile, partly degenerated 2 to 3 mm long coiled nematode in the anterior chamber. CONCLUSION: Results from DNA analysis were most consistent with a member of the Trichostrongylus or Metastrongylus genera, or a new nematode species.
Subject(s)
Anterior Chamber/parasitology , Eye Infections, Parasitic/diagnosis , Iris/pathology , Iritis/diagnosis , Nematoda/isolation & purification , Nematode Infections/diagnosis , Animals , Diagnosis, Differential , Eye Infections, Parasitic/parasitology , Humans , Iritis/parasitology , Male , Middle Aged , Nematode Infections/parasitology , Severity of Illness IndexSubject(s)
Acanthamoeba Keratitis/parasitology , Acanthamoeba/growth & development , Acanthamoeba/isolation & purification , Acanthamoeba Keratitis/pathology , Animals , Cornea/parasitology , Cornea/pathology , Disease Models, Animal , Evaluation Studies as Topic , Iritis/parasitology , Iritis/pathology , Rabbits , Steroids/administration & dosageABSTRACT
Stromal keratitis and iritis developed in the left eye of a healthy 45-year-old man with no history of ocular disease, trauma, or contact lens wear. The clinical course over a 2-year period was characterized by progressive central disciform keratitis, recurrent anterior stromal patchy infiltration, and iritis which was partially controlled with topical corticosteroids and broad-spectrum antibiotics. Results of bacterial, viral, fungal, and chlamydial cultures were negative. Results of histopathologic examination of a corneal biopsy specimen and, later, a penetrating keratoplasty specimen showed many extracellular and intracellular spores in degenerating keratocytes. By electron microscopy there were encapsulated oval structures measuring approximately 3.5 to 4 microns in length x 1.5 microns in width. Mature spores had well-developed cell walls that contained two abutted nuclei (diplokaryon) and a redundant polar tubule with six coils. These structures are characteristic of a protozoa in the genus Nosema.
Subject(s)
Corneal Diseases/parasitology , Eye Infections, Parasitic/diagnosis , Protozoan Infections/diagnosis , Animals , Corneal Diseases/diagnosis , Corneal Diseases/pathology , Corneal Diseases/surgery , Eukaryota/isolation & purification , Eukaryota/ultrastructure , Eye Infections, Parasitic/pathology , Eye Infections, Parasitic/surgery , Humans , Iritis/parasitology , Keratitis/parasitology , Keratoplasty, Penetrating , Male , Middle Aged , Protozoan Infections/pathology , Protozoan Infections/surgeryABSTRACT
An 8-year-old girl complained of progressive pain, visual loss and photophobia in her right eye for 1 week. Treatment with local steroids for acute iritis had not been successful. Slitlamp examination revealed a marked cellular and fibrinous inflammatory reaction of the anterior chamber and a whitish, fibrin-like structure on the surface of the iris. There was mild serum eosinophilia and leucocytosis. The suspected organic material was removed surgically. By light and electron microscopy, parts of the wall of a helminthic parasite were discovered, anatomically consistent with the diagnosis of an immature stage of Taenia solium found in cysticercosis. Such cases of intra-ocular parasitosis are described very rarely but might still occur, although there is no history of suspicious typical exposition to parasites. It is important to know that eosinophilia may be insignificant or even absent and that complete surgical removal will be the only successful treatment.
