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In daily life, we can not do without mobile phones, computers and other electronic products, contact lenses are also widely used; therefore, dry eyes, eye pain, itchy eyes, foreign body sensation and other uncomfortable symptoms are very common. In addition to excessive use of the eyes and the wearing of contact lenses, these symptoms of eye discomfort may also be infected with parasites.
Recently, one such Chinese case was featured in the New England Journal of Medicine (NEJM). A young man who had a foreign body sensation in his right eye with itching eventually found out that the cause was infection with a parasitic worm. The patient's symptoms disappear completely and there is no recurrence after removal of the worm. The case is from the team of ophthalmic surgery from Shantou University, Hong Kong Chinese University and Professor Chen Weiqi of Shantou International Eye Center, with Dr. Huang Zijing of Shantou International Eye Center as the first author and corresponding author.
截图来源：The New England Journal of Medicine
The patient is a 34-year-old male.
Because of the foreign body sensation in the right eye with itching, he went to the eye clinic for treatment.
Past history: There is no previous medical history, and the dog lives on a farm.
Auxiliary examination: Slit lamp microscopy shows 2 live worms under the upper eyelid (as shown in the figure below).
Image source: References[1]
Local anesthetics are given and worms are removed using fine forceps. The body is sent to a university parasitology laboratory for examination, which is identified as Theracia callipaeda.
Thelazia callipaeda is a parasitic worm that is the ultimate host for dogs, rabbits, cattle and humans, carried and transmitted by drosophilid flies (intermediate host) and feeds on eye secretions. People who are in close contact with livestock and live in unsanitary conditions are at greater risk of developing the disease.
Diagnosis: fundus flukes.
Follow-up: 1 month after removal of the worm, the patient no longer has a foreign body sensation in the eyes, and the itching subsides.
Resources [1] Stephanie V. Sherman, M.D.,（2021）. Ocular Thelaziasis. . N Engl J Med, DOI: 10.1056/NEJMicm2032962
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