|Year : 1975 | Volume
| Issue : 3 | Page : 39-40
SK Mehrotra, BK Sofat
H.P. Medical College, Simla, India
S K Mehrotra
Registrar in Ophthalmology, HP. Medical College, Simla-171001.
|How to cite this article:|
Mehrotra S K, Sofat B K. Ocular cysticercosis. Indian J Ophthalmol 1975;23:39-40
With the imporved water supply, living and hygienic conditions and better inspection of meat, the cysticercus cellulosae stage of Taenia solium in man is uncommonly met these days, as is also evident from the increasingly sporadic reports of it in the literature. However, cases of cysticercosis cellulosae are still occasionally seen in humans, the chief sites of such cysts being skeletal muscles and subcutaneous tissues. The involvement of extraocular muscles is rare.
Recently we saw the condition in a seven year old child wherein cysticercus cellulosae cyst was found adherent to the sheath of the left medial rectus muscle. It has been considered pertinent to report this case because of the relative rarity of the condition these days, unusual site of the cyst and the young age of the patient.
| Case Report|| |
P.S. seven year old male child was brought to eye department of H.P. Medical College, Hospital Snowdon, Simla with the complaints of a progressively in creasing swelling in the left eye of 12 days duration.
Examination of left eye revealed a rounded cystic swelling of about 10 mm x 10 mm just lateral to the caruncle, partly covered by the plica semilunaris [Figure - 1]. The swelling was bluish white in colour with blackish speck just below its centre. The wall of the cyst was tense, with overlying conjunctiva slightly suffused and adherent over the most prominent portion of the swelling. It was slightly tender on pressure, irreducible and fixed to the globe. Ocular movements were full. Regional lymph nodes were not enlarged. No other abnormality was detected in the eye or ocular ade-txa. Fundus seen under full mydriasis was normal.
Right eye was normal. A provisional diagnosis of a parasitic cyst was made. General examination revealed no other abnormality.
| Investigations|| |
Routine laboratory investigations were non contributory. Repeated microscopic examination of stools by direct and concentration method did not reveal any evidence of parasitic infestation. Radiographic examination of the orbit and skull was negative.
| Treatment|| |
The cyst was removed in torn under general anaesthesia. On the operation table the swelling was found to be firmly adherent to the medial rectus muscle sheath so much so that a part of the sheath had to bf removed along with the growth.
The patient was discharged from the hospital with good cosmetic result and full range of ocular movement.
| Follow up|| |
The child came for check up after two months. Three small cystic swellings were noted at the same site [Figure - 2]. The child was kept under regular observations and no further increase in the size and number of the cystic swellings noted.
| Histopathology|| |
Histo-pathological examination confirmed the clinical diagnosis of the cyst being that of cysticercosis in association with the sheath of medial rectus muscle.
| Discussion|| |
Cysticercosis infestation in the indigenous Indian population is rather rare due largely to the vegetarian habit and insignificant use of pork amongst the non-vegetarian population. It is not surprising thus, that there have been few reports of ocular cysticercosis from India ,.
Most common locations of cysticercosis cellulosae are the subcutaneous tissue, skeletal muscles, brain  , vitreous and under the conjunctiva  . The reports of such cysts occuring in association with the extra ocular muscles are frequent. In our case the cyst was firmly adherent to the sheath of the left medial rectus muscle so much so that a part of the muscle sheath had to be sacrificed while removing the cyst. These cysts probably develop in the flat ribbon shaped extra ocular muscles, but are extruded into the sub-conjunctival space by the frequent movements of the muscles, once they come to lie in loose sub-conjunctival tissues they develop more rapidly and become conspicuous.
Cysticercosis is a disease of adult life, few cases are reported below ten years of age Ocular cysticercosis would be rarer still below this age. From that point of view the case under report is interesting, as the child was only seven year old and had a well developed cysticercosis cyst attached to the sheath of the left medial rectus muscle.
| Summary|| |
An interesting case of ocular cysticercosis in close association with left medial rectus muscle sheath in seven year old male child is reported.
| References|| |
|1.||Chadha, A.C, 19 , 2, Amer. J. Ophthal. 53, 3, 529. |
|2.|| Duk-Elder, S., 1962, System of Ophthalmology VIII, Part 1423. Pub. Henry Kimpton, London. |
|3.||Dunlop, D. and Alstead, S., 1966, Text book of Medical Treatment Tenth Ed. 227. Pub. E & S Livingstone Ltd. U.K. |
|4.||Manson-Bahr, P.H., 1954, Manson's Tropical Disease. Fourteenth Ed. 817. Pub. Cassell & Co. Ltd. London. |
|5.||Malik, S.R.K., Gupta, A.K. and Chaudhry, S., 1968, Amer. J. Ophathal. 66, 1168. |
[Figure - 1], [Figure - 2]