Abstract
BackgroundOcular parasitosis can cause eye damage, which contribute to eye symptoms such as burning, itching and even blindness. It is uncommon to see the parasitosis lying in the sclera layer, neither it causing pterygium. Here, we present an unusual case of a secondary pterygium caused by intrascleral worm.Case presentationA 52-year-old women complained about discomfort in right eye for 6 years. Slit-lamp examination indicated a thickened triangular layers of conjunctiva extending from the nasal edge to the cornea. The diagnosis was pterygium in the right eye. To our surprise, after scleral of nasal side exposed, we could see a tiny fistula right in the sclera which lied right under the pterygium, with an alive and motile worm inside. An intrascleral fistula was noted. Then the worm was removed by forceps from the fistula, which was creamy white, thread-like and 1 cm long.Discussion and conclusionsAs far as we known, it is the first case of an intrascleral worm hidden beneath the conjunctiva which caused the secondary pterygium. It is hard to know the etiology of the secondary pterygium which caused by parasitosis in the scleral fistula untill excision surgery. It is hard to imagine the worm was living in the sclera of the patient for a long-time.
Highlights
Discussion and conclusionsAs far as we known, it is the first case of an intrascleral worm hidden beneath the conjunctiva which caused the secondary pterygium
Ocular parasitosis can cause eye damage, which contribute to eye symptoms such as burning, itching and even blindness
As far as we known, it is the first case of an intrascleral worm hidden beneath the conjunctiva which caused the secondary pterygium
Summary
Cases of intrascleral worms have been rarely reported, especially those hidden beneath the pterygium. The origin of the parasitosis was hard to know, we could only surmise it comes from conjunctival vessels, migrating to the surface of the scleral, and caused a fistula. Pterygium is a chronic inflammation process [8], and long-term mite infection can cause ocular chronic inflammation, which may play a role in the development of pterygium. The pterygium recurrence rate was higher in patients with mite infection, which may relate to chronic inflammation mediated by T helper cell 1 7[11]. To the best of our knowledge, this is the first case of an intrascleral worm hidden beneath a secondary
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