Riffat Rashid

Abstract

Loa loa is a nematode that is highly endemic in the tropical rainforests of Western and Central Africa. It is also known as “African eye worm”. Occasionally the adult parasite is seen in the subcutaneous tissue space of humans and occasionally into the subconjunctival space. Our case is a 29-year-old male presented to the outpatient department with history of swelling, redness and foreign body sensation in the inferior bulbar conjunctiva of his right eye. Slit lamp examination shows, a nodular swelling in the inferior conjunctival space and diagnosed as subconjunctival granulomatous lesion. In the operation theater, the lesion was explored and a live worm was removed from the subconjunctival space. The worm was measured about 3.5 cm in length. The worm was confirmed to be a Loa loa adult specimen. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. Ophthalmologists should be aware of the typical manifestations and possible unusual presentations. An increasing number of subconjunctival Loa loa cases are reported from non-endemic areas are due to increased travel and migration. This report illustrates an unusual ocular disease, which is usually not found outside of Africa, but easily diagnosed and treated.   Keywords: Loa loa, Subconjunctival, Amniotic membrane graft, Eosinophilia, Calabar swellings, Albendazole

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Abstract

Introduction: Capillary haemangiomas or infantile haemangioma of the eyelid are the most common tumors of infancy. Infantile haemangioma appears soon after birth. Tumors that involving the periorbital area require treatment. Objectives: To evaluate the rate of regression by size and to evaluate color change of infantile eyelid haemangioma treated with oral propranolol. Methods: The prospective study was carried out in the department of Oculoplasty, Ispahani Islamia Eye Institute and hospital during the period of January 01, 2013 to December 31, 2014. We included all patients of 1 months to 60 months, clinically diagnosed infantile eyelid haemangioma of either sex attended in the out-patient department during the study period with relative indication for treatment. The exclusion criteria were: haemangioma with presenting life-threatening condition, cardiovascular disorders contraindicating propranolol use, family history of bronchial asthma, or recent/repeated outbreak of wheezing, low birth weight newborns and previously treated with intralesional Triamcinolone. Patients were treated by oral Propranolol: 2 mg/ kg /day. Follow-up visits were initially scheduled after 2 and 4 weeks of therapy and then monthly for six months. Results: This study included a total of 93 patients with infantile eyelid haemangioma. The age of the patients in the study group ranged from 1 months to 42 months. Male 36 and female 57. Right eye involved in 40 patients and left eye 53. After 6 months of treatment, overall color clearance was seen in all patients, 70(75%) had an excellent response. After 6 months of treatment, overall regression of size was seen in all patients. In 75(80%) patient had an excellent response. Conclusion: Propranolol has been found clinically effective and also cost-effective in the treatment of infantile eyelid haemangioma. It also demonstrated better tolerance with minimal adverse effects. Keywords: Capillary haemangioma, Intralesional triamcinolone, Propranolol, Periorbital.    

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