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CASE REPORT
Year : 1993  |  Volume : 41  |  Issue : 4  |  Page : 188-189
 

Subconjunctival cysticercus cellulosae


Department of Ophthalmology, Rajendra Medical College Hospital, Ranchi, India

Correspondence Address:
R Y Singh
Department of Ophthalmology, Rajendra Medical College Hospital, Ranchi, Bihar
India
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PMID: 8005653

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How to cite this article:
Singh R Y. Subconjunctival cysticercus cellulosae. Indian J Ophthalmol 1993;41:188-9

How to cite this URL:
Singh R Y. Subconjunctival cysticercus cellulosae. Indian J Ophthalmol [serial online] 1993 [cited 2013 May 25];41:188-9. Available from: http://www.ijo.in/text.asp?1993/41/4/188/25594


Cysticercus cellulosae, the larval form of Taenia solium (Tape worm), affecting the human eye is not uncommon. Human infection occurs on eating raw or inadequately cooked infected pork, consuming food or water contaminated with faecal matter containing the ova, or due to auto-infection. [1] Sommering [2] first reported a case of ocular cysticerosis. Since then, several reports have appeared in the literature. The parasite's most favoured site in the eye is vitreous and sub­retinal space, followed by subconjunctival tissue. [3],[4] A case of subconjunctival cysticercus cellulosae in the right eye of a young vegetarian man is reported here.


   Case report Top


A 17-year-old Hindu man presented with a progessive swelling in the right eye of 3 months' duration. Except for cosmetic disfiguration and mild discomfort in closing the right eyelids, he had no other complaint.

The patient was of low socio-economic status and a strict vegetarian. General physical and systemic examination revealed no abnormality. The right eye had a smooth, pinkish, hemispherical, subconjunc­tival cystic swelling of approximately 10 x 6 mm size, near the inner canthus [Figure - 1]. It was loosely adher­ent to the eyeball, nonreducible, and slightly tender. Its outer border was approximately 4 mm away from the limbus, inner border extended to plica semilunaris, and upper and lower margins extended upto fornices. The conjunctival vessels over and around it were mildly congested. The left eye was normal. Visual acuity in both eyes was 6/6, and ophthalmoscopic examination did not reveal any abnormality. Routine laboratory investigations and radiographic examination of orbit and skull were within normal limit.

The cyst was excised intact under local anaesthesia and sent for pathological examination. The gap in the conjunctiva was repaired. The postoperative period was uneventful.

On gross examination, the cyst was oval in shape and measured 7 x 5 mm in size. It was thin-walled and translucent, and had a white opaque dot-like area at one point which indicated the position of scolex. The histopathological examination showed the presence of body canal of Cysticercus [Figure - 2] as tortuous lumen lined by cuboidal epithelium and surrounded by fibrous tissue showing few inflammatory cells. The diagnosis of Cysticercus cellulosae was established on the basis of its gross and microscopic morphology.


   Discussion Top


Ocular dissemination of Cysticercus cellulosae is well known and is evident from several such reports in the literature. The parasite's most favoured site in the eye is vitreous and subretinal space, followed by sub­conjunctival tissue [3],[4]The Cysticercus in the prsent case, was subconjunctival and was located in the right eye, which is slightly less commonly involved than the left eye.[5],[6]

Our patient was a strict vegetarian and his relevant laboratory investigations were normal. Apparently, our report cautions against ruling out Cysticercus cellulosae in cases where there is no history of eating pork and all the relevant investigations are normal, and calls for proper sanitation and hygiene in controlling this parasitic disease.

 
   References Top

1.Swatz WG. Medical Parasitology. p.127, McGraw-Hill, New York, 1956.  Back to cited text no. 1    
2.Duke-Elder S. System of Ophthalmology. Vol.XV. p.40, Henry Kimpton, London, 1976.  Back to cited text no. 2    
3.Duke-Elder S. System of Ophthalmology. Vol.VIII (part I), p.423, Henry Kimpton, London, 1965.  Back to cited text no. 3    
4.Bartholomew RS. Subretinal cysticercosis. Am J Ophthalmol. 79:670, 1975.  Back to cited text no. 4    
5.Sen DK, Mathur RN, and Thomas A. Ocular Cysticercosis in India. Br J Ophthalmol. 51:630, 1967.  Back to cited text no. 5    
6.Malik SRK, Gupta AK, and Chaudhary SK. Ocular cysticercosis. Am J Ophthalmol. 66:1168, 1968.  Back to cited text no. 6    


    Figures

[Figure - 1], [Figure - 2]



 

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