Human ocular thelaziasis caused by gravid Thelazia callipaeda - A unique and rare case report

Abstract

An 80-year-old male reported to the clinic with complaints of diminished vision, foreign body sensation, and occasionally some black object moving in front of the right eye. Detailed ocular examination revealed three slender creamy white live worms in the conjunctival sac of the right eye. Total three worms were retrieved and sent to the pathology department for detailed examination. The worm was identified as gravid Thelazia callipaeda. As per the search results in PubMed and Cochrane search engine, this is the first report of human case of gravid Thelazia infestation with simultaneous existence of embryonated or ensheathed eggs and primary-stage larvae in the same worm.

Keywords: Gravid; Thelazia; human; larvae; ocular.

Figure 1

Life cycle of Thelazia callipaeda

Figure 2

Creamy white color slender worms retrieved from the conjunctiva in OT

Figure 3

Ventral portion of the worm with rectangular buccal cavity and transverse striations on its surface, directly under microscope (Axioskop 40 with AxioCamMRc, Zeiss, Germany, 40×)

Figure 4

Embryonated eggs in the abdomen of the worm with scarliform transverse striations

Figure 5

Unstained section showing portion of abdomen of adult worm with coiled primary-stage larvae

Figure 6

Portion of the worm with extruded eggs on pressing the abdominal cavity (40×)

Figure 7

Retrieved larvae from the abdomen in hematoxylin and eosin stain showing cross-striations consistent with primary-stage larvae of Thelazia callipaeda