|Year : 1980 | Volume
| Issue : 2 | Page : 89-90
Immature stage of wuchereria bancrofti in the human eye
A Joseph1, NSD Raju2
1 Medical College, Trivandrum, India
2 District Hospital, Ernakulam, Kerala, India
Medical College Trivandrum, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Joseph A, Raju N. Immature stage of wuchereria bancrofti in the human eye. Indian J Ophthalmol 1980;28:89-90
As far as human filariasis is concerned there are only two species which have pathological bearing in India, namely Wuchereria bancrofti and Brugia malayi. They generally cause swelling of the limbs and genitals and ocular infection is a rarity. There are very few reports of intra-ocular filariasis due to these two species. Perhaps the earliest paper on this is by Nayar & Pillai, who reported an adult worm lying in the subretinal space. There are no other records about the adults of these two species from the human eye. However, there are a few reports on the occurrence of the "Microfilariae" in almost all the tissues of the eye from India.,,,. A case of infection in the iris by an immature W. bancrofti worm is presented.
| Case report|| |
A male patient aged 42 years reported to the Ophthalmic department of the District Hospital, Ernakulam. His main complaints were pain, irritation, redness, and occasional watering from the left eye for one week. He was also having a fluttering sensation in the left eye for one week. He was also having a fluttering sensation in the left eye for the last one and a half months. He complained of a steady decline in the visual acuity in the affected eye.
On examination the left eye showed narrowing of the palpebral fissure, slight oedema of lids, moderate circumcorneal congestion and hazy cornea. Aqueous was slightly turbid, pupil small and sluggishly reacting to light. On the iris there was a white circular patch two m.m. in diameter and slightly elevated from the surface at the one o' clock position, midway between the pupillary margin and the root of the Iris. Two slender white thread like projections were seen arising from this patch, and were jutting into the anterior chamber and showed active wriggling movement.
His vision was 6/ 12 in the left eye and 6/6 in the right eye. Fundus view was hazy due to haziness of the cornea in the left eye. Oblique illumination showed fine K.P.'s on the back of the cornea. Intra ocular pressure was 22 m.m. Hg. LE and 17.3 m.m. Hg. RE with 5.5 g. weight. Right eye was normal.
On general examination the patient was moderately built and healthy. Routine urine, stool and blood examinations showed nothing abnormal. Night blood was negative for microfilaria.
A provisional diagnosis of Iridocyclitis with a live intra ocular parasite was made. A complete iridectomy was done and the worm was extracted along with some Iris tissue. The worm was alive and showed wriggling movement. Post operative period was uneventful. Iridocyclitis subsided, cornea and aqueous became clear and K. P.'s disappeared. The patient has been reporting for checkup once in a month.
The extracted worm was white, 6.5 m.m. long and 80 microns broad at the middle portions. The anterior end showed a distinct oral region, cuticles were smooth and posterior end tapers [Figure - 1][Figure - 2]. The morphological characters showed that it was the immature stage of W. bancrofti.
| Discussion|| |
Even though the present case is an isolated one it has clinical and parasitological significance. All the previous reports are on the ocular infections due to the microfilariae of W. bancrofti and B. malayi. This is the first time that the developing stage has been seen in the iris. Usually the microfilaria, which measures nearly 200 u in length, remains in the host's blood only upto 10-60 days. Further development is possible only in the intermediate host, mosquito, where it assumes a length of I to 1.6 m.m. and remains in the proboscis. This stage finds its way to the human host though the wound caused while the mosquito bites. It penetrates the subcutaneous lymphatic vessels and reaches the maturation site in the lymph glands and lymphatic vessels and develops into an adult worm. This particular worm was lodged in the iris and started development and by about 12 months attained a length of 6.5 m.m. The fluttering sensation and irritation of the eye for one and a half months complained of by the patient was coincident with the worm's presence. Had it not been removed, further development and its sequelae would have been possible, causing damages to the iris and. surrounding tissues.
| Summary|| |
The filarial infection in the iris due to the immature stage of W. bancrofti is reported.
| Acknowledgement|| |
The authors are grateful to the Director of Health Services and Principal, Medical College Trivandrum for permitting them to publish this paper.
| References|| |
Nayar, K.K. and Pillai, A.K., 1932, Brit. J. Ophthalmol. 16: 549.
Anandakannan, K. and Gupta, C.P., 1977, Brit. J. Ophthalmol. 61: 263.
Thomas, A. Oammen, M.M, Alexander, T.A., 1978, Ind. J. Ophthalmol. 25: Iv : 43.
Joseph, A. George Thomas, P. and Subramaniam, K.S. 1976, Ind. J. Ophthalmol. 24, Iv: 20-2.
George. M. and Kurien, C. 1978, J. Ind. Med. Assoc. 77 : 123.
[Figure - 1], [Figure - 2]