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Year : 1976  |  Volume : 24  |  Issue : 2  |  Page : 21-22

Marginal keratitis produced by phthirus pubes

Little Flower Hospital, Angamaly, Kerala, India

Correspondence Address:
T P Ittyerah
Little Flower Hospital, Angamaly, Kerala
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Source of Support: None, Conflict of Interest: None

PMID: 1031389

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How to cite this article:
Ittyerah T P, Fernandez S T, Kutty K N. Marginal keratitis produced by phthirus pubes. Indian J Ophthalmol 1976;24:21-2

How to cite this URL:
Ittyerah T P, Fernandez S T, Kutty K N. Marginal keratitis produced by phthirus pubes. Indian J Ophthalmol [serial online] 1976 [cited 2021 Apr 19];24:21-2. Available from: https://www.ijo.in/text.asp?1976/24/2/21/31529

Phthirus pubes (Crab louse) is reported to produce blepharitis and this is known as phthiriasis palpebrarum[2]. Along with blephar­itis, conjunctivitis can occur. Bose, Ahmed and Roy[1] described folliculitis, blepharitis, con­junctivitis and blue spot in lid margin as the ophthalmic complications caused by phthirus pubes. According to Duke Elder[3], keratitis from parasitic infection is extremely rare. This case is reported because of the rarity of corneal involvement in crab louse infestation of the eye.

  Case Report Top

Mr. B, a 21-year old young college boy attended the out-patient department of Little Flower Hospital, Angamaly, for pain in the eyes and redness. On examination, superficial marginal keratitis was noticed in the right eye. There were small white areas of kera­titis on the corneal periphery at 6 o'clock, 8 o'clock, 11 o'clock and 1 o'clock positions in the cornea about 2 mm. away from the limbus [Figure - 1] The lesions did not take fluorescein stain. Bio-microscopic examination revealed that the lesions were sub-epithelial. He was treated with atropine eye ointment 1% b.d., framycetin 0.5% eye drops t.i.d. and the right eye was patched.

The lid condition was overlooked. The patient did not have relief. On re-examination after 5 days blepharitis was noted in both eyes and live louses (Phthirus pubes) were noticed along with their eggs in both eye lashes [Figure - 2],[Figure - 3],[Figure - 4]. He was treated with sulphaceta­mide 20% and oxytetracycline 1% eye ointment, lid margins cleaned thoroughly and louses removed. The condition subsided in one week's time.

  Discussion Top

The crab louse belongs to Anoplura order, in the Pediculidae family in the phthirus genera. The abdomen of the louse is broader so that it resembles a crab. The females lay 2 to 3 eggs per day and are cemented on the eye lashes firmly. The eggs hatch out in 6 to 8 days' time. The spread is mainly by means of eggs which become attached with the lashes.

The classical treatment for phthiriasis palpebrarum is to shave off the lashes and apply aniline dye, yellow oxide of mercury or sulpha­cetamide ointment.

The cause for the associated conjunctivitis and keratitis could be irritation by the excre­tions, secretions and cementing substance of the crab louse with or without added infection.

  Summary Top

A case of marginal keratitis produced by p thirus pubes is reported and possible mecha­nism discussed.

  References Top

Bose, J., Ahmed, E. and Roy, S.N., 1975, Bengal Ophthal. Jour„ 3, 31.  Back to cited text no. 1
Duke Elder, S., 1959, Parsons' Diseases of the Eye, 13th Edition, 501, J.&A. Churchill, London.   Back to cited text no. 2
Duke Elder, S., 1965, System of Ophthalmology, Vol. VI, 801, Henry Kimpton, London.  Back to cited text no. 3


  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]


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