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   Table of Contents      
Year : 1977  |  Volume : 25  |  Issue : 4  |  Page : 41-42

Intra ocular Thelazia-(a case report)

1 Department of Ophthalmology, Pt. J.N.M. Medical College, Raipur, India
2 Department of Pathology, Pt. J.N.M. Medical College, Raipur, India

Correspondence Address:
P K Mukherjee
Department of Ophthalmology, Pt. J.N.M. Medical College, Raipur
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Mukherjee P K, Verma S, Agrawal S. Intra ocular Thelazia-(a case report). Indian J Ophthalmol 1977;25:41-2

How to cite this URL:
Mukherjee P K, Verma S, Agrawal S. Intra ocular Thelazia-(a case report). Indian J Ophthalmol [serial online] 1977 [cited 2021 Mar 8];25:41-2. Available from: https://www.ijo.in/text.asp?1977/25/4/41/34613

Thelazial infestation is common parasito­logical ocular involvement in dogs and horses in South-east Asia and North America. Involve­ment of the human eye by this parasite is relatively uncommon and is confined to conjunctive and lid. [2],[3],[4],[5],[6]

Intra-ocular involvement is most uncommon. So far only one case has been reported. Choudhry [1] extracted a living thelazia from the anterior chamber of an East-Pakistani girl.

  Case Report Top

Fulmani, a 13 year female orphan, an immigrant from Bangla Desh, presented in Ophthalmic O.P.D. on 15.7.74 with complaints of watering, redness and dull pain in the right eye for 15 days. She was symptom-free 15 days earlier except that she could not see with the right eye. The loss of vision in the right eye was first detected on routine medical examination in the school about four years ago. She had an old treatment card showing that she did not have perception of light in the right eye at that time too and was diagnosed as a case of juvenile glaucoma right eye for which she had not taken any treatment.

Examination of the right eye showed circum-corneal congestion, fine K.P. at the lower part of the cornea, ciliary tenderness, aqueous flare ++. The iris was oedematous and showed a small nodule about 1 m.m in size at four 0' clock position 1 m.m. inside the limbus. The pupil was semidilated and not reacting to light.

The lens was normal. There was no perception of light. The fundus examination showed glaucomatous optic atrophy. The tension was 34mm. Hg. The left eye was normal in all respect.

In view of the iridocyclitis with glaucoma, the patient was put on diamox 1 Tablet two times a day. Atropine eye ointment 1% and pyrimon eye drops three times a day were instilled in the affected eye. With the above treatment the tension came down to 14.00 m.m. Hg. and the symptoms of acute iridocyclitis subsided within 48 hours. The treatment was continued and laboratory tests for probable cause of iridocyclitis were carried out which remained non-conclusive.

Though the symptoms were controlled the nodule started growing in size, in seven days assumed a rod­like structure. On 22.7.74 a thread worm like structure was seen floating in the anterior chamber with one end still attached to the iris. [Figure - 1]

It was removed alongwith a sector of iris under general anaesthesia the next day. The worm was identi­fied as Thelazia Calipoeda. The patient made an uneventful recovery in the next ten days.

  Discussion Top

Thelazia is a spheroid nematode found in Japan, China, South-east Asia, Burma, Indian subcontinent and some parts of the U. S. A. mostly in mammals. Ten species of genus thelazia have been indentified within the conjuctival sac of mammals and similar number have been identified in birds. [4] The life-cycle of thelazi has not yet been fully worked out. An orthopod factor has been postulated. In man the ocular involvement so far reported are as conjunctival nodules and swellings in the lid. Only one case of intraocular involvement has been reported so far from Bangladesh. [1] The present patient though now residing in India originally belonged to Bangladesh and migrated later.

Involvement of conjunctiva and lid explained on the basis of transfer of the ova or larva by flies, in the endemic area because in some cases patient with conjunctival involvement had a history of a fly or gnat coming in contact with the eyes one or two months prior to the onset of conjunctivitis. [4]

Chaudhry was unable to explain the route of intra-ocular involvement. We are not nearer to any positive conclusion.

  Summary Top

A case of intra-ocular involvement by nema­tode thelazia causing iridocyclitis has been presented. The iridocyclitis healed after removal of the worm.

  References Top

Choudhry, A.R. 1969, Amer. J. Ophthal., 65, 773.   Back to cited text no. 1
Duke Elder, S. 1965, System of Ophthalmology, 8, Part I. Henry Kimpton London 416,  Back to cited text no. 2
Duke Elder S. 1974, System of Ophthal., 13, Part I, 193, Henry Kimpton London.  Back to cited text no. 3
Kenierim. R. and Jack. M.K. 1975, Arch. Of Ophthal., 93, 522-3.  Back to cited text no. 4
Mori, R., Okuda, K. and Shiragami, M., 1969, Folia Ophthal., Jap., 20, 639-4.  Back to cited text no. 5
Sorsby, A., 1963, Modern Ophthalmology, 2, p. 249, Buttorwoorth, London.  Back to cited text no. 6


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