Asunto(s)
Lesiones de la Cornea , Cuerpos Extraños en el Ojo/diagnóstico , Lesiones Oculares Penetrantes/diagnóstico , Iritis/diagnóstico , Lepidópteros , Hipertensión Ocular/diagnóstico , Tomografía de Coherencia Óptica , Enfermedad Aguda , Animales , Antibacterianos/uso terapéutico , Antihipertensivos/uso terapéutico , Niño , Quimioterapia Combinada , Cuerpos Extraños en el Ojo/tratamiento farmacológico , Cuerpos Extraños en el Ojo/parasitología , Lesiones Oculares Penetrantes/tratamiento farmacológico , Lesiones Oculares Penetrantes/parasitología , Femenino , Glucocorticoides/uso terapéutico , Humanos , Iritis/tratamiento farmacológico , Iritis/parasitología , Midriáticos/uso terapéutico , Hipertensión Ocular/tratamiento farmacológico , Hipertensión Ocular/parasitología , Agudeza VisualRESUMEN
A middle-aged Asian gentleman presented with four weeks' history of recurrent redness, pain and deterioration of vision in his right eye. He was diagnosed with chronic, unilateral, granulomatous hypertensive uveitis. During one of the serial examinations a single, off-white, extremely motile, thread-like worm about 15 mm long was noted in the anterior chamber. Surgical retrieval of the worm was unsuccessful. The worm disappeared in the eye and was never seen again. Patient suffered from chronic waxing and waning granulomatous inflammation with uncontrolled high intraocular pressure despite treatment. The vision dropped down to no perception of light. Therapeutic success in such patients depends upon early and complete surgical removal of the worm, which could be a real challenge as worms are highly motile and only visible sporadically, as in this case. Ocular parasitosis should be kept in mind as a differential diagnosis in treating non-responsive chronic hypertensive granulomatous inflammation, especially if the patient is of Southeast Asian origin or has recently visited the region.