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September 2003

Nematode in the Anterior Chamber

Arch Ophthalmol. 2003;121(9):1338-1339. doi:10.1001/archopht.121.9.1338

A 13-YEAR-OLD girl complained of decreased vision in her left eye of 1 month's duration. There was no history of exposure to animals or contaminated meat products. She denied experiencing any pain or periorbital swelling. Her visual acuity was 20/20 OD and 20/200 OS. Results of a slitlamp examination of the right eye were normal. Examination of the left eye revealed a highly motile worm of 5 to 10 mm in length floating in the anterior chamber (Figure 1 and Figure 2). A funduscopic examination revealed a macular chorioretinal scar in the left eye. Blood counts revealed an elevated erythrocyte sedimentation rate of 42 mm/h. A peripheral blood smear was notable for eosinophilia, but no microfilariae were seen. A stool ova and parasite examination revealed Entamoeba cysts but no helminths. The patient underwent surgical removal of the worm via a paracentesis wound. Histopathological analysis of worm segments confirmed that they were consistent with a nematode. Species identification was not possible. The patient was referred to a pediatrician for systemic broad-spectrum antihelminthic therapy.

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