When 23-year-old Collins returned to Dubai after a short trip to his home in Cameroon, he didn’t return as fresh as he would usually do like his previous trips. This time, he returned with a severe eye pain and irritation in the eye-ball that persisted for three days. He got the shock of his life when he was told he had a live worm crawling in his eye!
Dr Anurag Mathur, specialist ophthalmologist at Aster Jubilee Medical Complex, said the patient visited him complaining of persistent pain in his eye for the last three days.
On close examination, Dr Mathur noticed a live worm crawling under the patient’s conjunctiva – the outer transparent layer of the eye. The patient was suffering from a condition called ocular filariasis caused by parasites or thread-like filarial worms. This patient had a worm called Loa Loa or African eye worm inside his eye.
While relatively uncommon in the UAE, parasitic infections of the eye are not as rare and unusual as it may sound. The unique structure of the human eye and its obvious exposure to the environment makes it vulnerable to infectious diseases caused by parasites. The type of infection depends on the kind of parasite that infects the eye, which mainly depends on the geographical location of a person, Dr Mathur explained.
This condition is rather rare in the GCC and is more common in regions like Africa and India. However, due to the large African population present in Dubai, various endemic diseases seen in those regions are common here. As of 2009, the condition was endemic to 11 countries, all in western or central Africa and an estimated 12-13 million people had the disease. The highest incidence of this condition was seen in Cameroon, Central African Republic, Nigeria, Gabon and Equatorial Guinea.
Ocular Filariasis is a blood-borne disease and people generally contract this disease through the bite of a deerfly or a mango fly. The parasite travels to various parts of the human body, through the bloodstream, causing infections. This condition is more prevalent in geographical areas where environmental factors and poor sanitary conditions favour the parasitism between man and animals. Travel history to endemic areas is important to determine the source of infection. In this case, the medium of infection remains unknown, however, it can be suggested that the patient would have contracted this condition from his home country.
“I have only seen two cases of parasitic infection in the eye at Aster Clinic till date. Ocular filariasis is, in fact, a very rare here though commonly found in Africa and India. Such cases are not unknown but are unusual given their rarity. The worm, 6cm in length and alive was removed from the patient’s eye indicating that the worm probably grew and developed into an adult inside the patient’s eye,” said Dr Mathur.
Considering the size of the worm when removed from the patient’s eye, the worm had housed itself in the patient’s eye for a few months. These worms do not cause blinding, although movement of the worm in the eye can cause excruciating pain. The patient did not experience any other symptoms but severe pain in his eye.
“There are different types of parasites that infect the human eye. Such infections are often difficult to diagnose because these worms are not visible to the naked eye. However, certain common indications like sensitivity to light, pain or swelling, loss of vision etc. are the most probable symptoms and must be reported to a doctor at the earliest,” he added.
“I was shocked when Dr Mathur informed me about a live worm in my eye and that I had to undergo a surgery to remove it. I suffered extreme pain in my eye for three days and I knew I had an eye infection but I scarcely dreamed that this could be the cause. The thought is terrifying, however, I am extremely grateful to Dr Mathur for his prompt diagnosis and treatment,” said Collins.
The procedure was carried out under topical anaesthesia and took only 10 minutes to complete. The worm was subjected to microscopic examination, revealing its gender as female, which increased the probability of the worm reproducing and multiplying inside the eye. The patient was further tested to check for infections in his blood which revealed that he had multiple worms known as micro filaria in his blood, which could, however, be treated with deworming medication.
Dr Sunita Prakash Vaidya, pathology specialist at Aster Medinova Diagnostic Centre and a microbiologist were involved in studying the patient’s blood samples and in identifying the type and sex of the worm. The post-operative period was minimal and the patient was given medication to cleanse his blood.
Dr. Anurag Mathur
Aster Clinic, Bur Dubai (AJMC)