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www.thelancet.com  Vol 379 March 17, 2012 e42

Clinical Picture

Lancet 2012; 379: e42

Published Online

 January 13, 2012

DOI:10.1016/S0140-

6736(11)61455-4

State Key Laboratory of 

Ophthalmology, Zhongshan

Ophthalmic Centre,

Sun Yat-sen University,

Guangzhou, China (H Lin MD,

X Liang MD)

Correspondence to:

Dr Xiaoling Liang, State Key

Laboratory of Ophthalmology,

Zhongshan Ophthalmic Centre,

Sun Yat-sen University,

Guangzhou 510060, China

liangxiaolingsums@yahoo.

com.cn

Eye can see a nest of worms!

Haotian Lin, Xiaoling Liang

In October, 2010, a 38-year-old woman presented withcreeping sensation in her right eye, but without anysystemic or visual symptoms. Her medical history wasnotable only for an unknown insect flying into herright eye during farm work about 3 months earlier.On examination, a live worm was seen moving out fromthe nasal upper eyelid of the right eye above theconjunctiva (figure A). This was further viewed withanterior segment optical coherence tomography(figure B). When proxymetacaine eye-drops were admin-istered, preparing the eye for surgical exploration, more

than two worms were seen moving (figure C, D). Theworm nest in the superior-nasal subconjunctiva tissue

Figure: Thelazia callipaeda

(A) On initial examination one worm is seen; (B) optical coherence tomography; (C and D) two worms seen after eye-drops are administered.

was completely cleared. The worms were all removedand identified as one female and two male Thelazia

callipaeda. The creeping sensations resolved immediately,with no recurrence after 6-month follow-up. Thelaziacallipaeda infects orbital cavities and associated tissues of man and other carnivores. Drosophila is its vector host,and it tends to infect individuals residing in poorcommunities in Asia, particularly in China.

Acknowledgments

This report was funded by the National Natural Science Foundation of China (30973899 and 81000389). The funding source had no involvement

in writing the report.

A B

C D