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   Table of Contents      
Year : 2020  |  Volume : 68  |  Issue : 11  |  Page : 2523

Conjunctival dirofilariasis presenting as a painless, cystic nodule: An unusual manifestation

1 Sai Eye Hospital, Nagpur, India
2 Ophthalmic Plastic Surgery Services, Aditya Jyot Eye Hospital, Mumbai, India
3 Bedge, Kulkarni & Pande, Pathology Laboratory, Nagpur, India

Date of Web Publication26-Oct-2020

Correspondence Address:
Dr. Shivani Bidaye Sule
Sai Eye Hospital, 145, Sai-Kripa, Dharampeth, Nagpur, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_712_20

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How to cite this article:
Bidaye Sule S, Nair AG, Sule S, Pande A. Conjunctival dirofilariasis presenting as a painless, cystic nodule: An unusual manifestation. Indian J Ophthalmol 2020;68:2523

How to cite this URL:
Bidaye Sule S, Nair AG, Sule S, Pande A. Conjunctival dirofilariasis presenting as a painless, cystic nodule: An unusual manifestation. Indian J Ophthalmol [serial online] 2020 [cited 2020 Nov 25];68:2523. Available from: https://www.ijo.in/text.asp?2020/68/11/2523/299102

Infection caused by the filarial parasite of the genus Dirofilaria, clinically known as Dirofilariasis, is a zoonotic helminthic infection that is largely endemic in Mediterranean countries and commonly affects animals, mostly dogs, raccoons, wolves and foxes.[1] Human infection is uncommon.[1] Mosquitoes are the vectors in the disease cycle and humans are the final host of this parasite.[1] Ocular dirofilariasis, although uncommon, has been reported from various parts of the world with reports of periorbital, subconjunctival, orbital and intraocular involvement.[2],[3],[4],[5],[6],[7] Previously published reports of conjunctival dirofilariasis have described patients presenting with ocular discomfort, intense pain, and redness.[6],[7] In our case, conjunctival dirofilariasis was found to manifest as a painless, cystic, nodular mass [Figure 1]a. Surgical removal of the lesion with histopathological confirmation is the preferred treatment with anti-helminthic therapy having no role in the management [Figure 1]b and [Figure 1]c. Dirofilariasis should be considered a differential diagnosis when evaluating a patient who presents with a painless cystic conjunctival mass, even in a traditionally non-endemic area.
Figure 1: (a) External photograph showing a cystic, nodular, conjunctival mass seen temporally, measuring approximately 8 mm in diameter; with overlying tortuous vessels. (b) Histopathological examination showing multiple cross sections of what appeared to be a parasitic nematode in a background of intense inflammatory reaction. (c) High power microscopy allowed identification of a multi-layered cuticle, inner longitudinal muscles (black arrows), lateral chords (yellow arrows), uterine cavity (yellow asterisk) and the intestinal lumen (black asterisk)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that their names and initials will not be published, and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Nath R, Gogoi R, Bordoloi N, Gogoi T. Ocular dirofilariasis. IndianJ Pathol Microbiol 2010;53:157-9.  Back to cited text no. 1
Chopra R, Bhatti SM, Mohan S, Taneja N. Dirofilariain the anterior chamber: A rare occurrence. Middle East Afr J Ophthalmol2012;19:349-51.  Back to cited text no. 2
[PUBMED]  [Full text]  
Gorezis S, Psilla M, Asproudis I, Peschos D, Papadopoulou C, Stefaniotou M. Intravitreal dirofilariasis: A rare ocular infection. Orbit 2006;25:57-9.  Back to cited text no. 3
Juri J, Kuzman T, Stiglmayer N, Tojagic M. A case of lacrimal gland dirofilariasis. Ophthalmologica2007;221:204-6.  Back to cited text no. 4
Mahesh G, Giridhar A, Biswas J, Saikumar SJ, Bhat A. A case of periocular dirofilariasis masquerading as a lid tumour. Indian J Ophthalmol 2005;53:63-4.  Back to cited text no. 5
[PUBMED]  [Full text]  
Kalogeropoulos CD, Stefaniotou MI, Gorgoli KE, Papadopoulou CV, Pappa CN, Paschidis CA. Ocular dirofilariasis: a case series of 8 patients. Middle East Afr J Ophthalmol 2014;21:312-6  Back to cited text no. 6
Mancera N, Applebaum RJ, Margo CE. Conjunctival Dirofilariasis Causing Symptoms for 1 Day. Ophthalmic Plast Reconstr Surg. 2018;34:e178.  Back to cited text no. 7


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