Paul Anita, Pammal Ashwin T
Birmingham and Midland Eye Centre City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
Indian J Ophthalmol. 2008 Nov-Dec;56(6):501-2. doi: 10.4103/0301-4738.43369.
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.
一名中年亚洲男性患者，右眼反复出现眼红、疼痛及视力下降4周。他被诊断为慢性、单侧、肉芽肿性高血压性葡萄膜炎。在一系列检查中的一次检查时，在前房发现了一条单一的、灰白色、活动极为活跃、线状的蠕虫，长约15毫米。手术取出蠕虫未成功。蠕虫在眼内消失，再也没有出现过。尽管接受了治疗，患者仍患有慢性波动性肉芽肿性炎症，眼压控制不佳。视力下降至无光感。对此类患者的治疗成功取决于早期彻底手术取出蠕虫，这可能是一项真正的挑战，因为蠕虫活动极为活跃，且如本例一样只是偶尔可见。在治疗无反应的慢性高血压性肉芽肿性炎症时，应将眼寄生虫病作为鉴别诊断考虑，特别是如果患者来自东南亚地区或近期去过该地区。
