Ocular myocysticercosis: Atypical presentation with unilateral blepharoptosis

Authors : Aye Myat Mon, Yogita Rajbhandari, Ben Limbu, Rohit Saiju

DOI : 10.18231/j.ijceo.2020.099

Volume : 6

Issue : 3

Year : 2020

Page No : 463-466

Background: Cysticercosis is a parasitic infection caused by Cysticercus cellulosae, the larval form of
cestode, Taenia solium. It is a preventable cause of blindness endemic in many developing countries
especially where there is poor hygiene and sanitation. Humans become infected by ingestion of
contaminated food and water. The most preferred locations are central nervous system (CNS), eyes, heart,
bladder, muscles and subcutaneous tissues. Ocular cysticercosis can be extraocular or intraocular and
may show different clinical presentations. We report a case of ocular cysticercosis which presented with
unilateral ptosis and mild pain.
Case: A young male patient presented with mild swelling and drooping of right upper eyelid for 2 weeks
associated with mild pain and redness on first 3 days. Ocular examination revealed ptosis and mild swelling
on temporal side of right upper eyelid. The swelling was soft in consistency with no tenderness. Levator
function was good with normal Bell’s phenomenon and ocular motility was in full in all cardinal gazes. The
computed tomography imaging of the orbit showed bulky right superior rectus muscle with ring enhancing
hypodense lesion suggestive of right eye myocysticercosis involving superior rectus muscle. The patient
was treated with oral albendazole and oral prednisolone for 4 weeks and a significant improvement of ptosis
was seen at 1 month follow up visit.
Conclusion: Extraocular muscle cysticercosis should be highly suspicious in young patients with unilateral
acquired blepharoptosis. Radiological investigations play a vital role in diagnosis and a complete resolution
can be achieved with standard medical therapy alone.

Keywords: Cysticercosis, Myocysticercosis, Orbital cysticercosis, Ptosis.


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