Journal List > J Korean Ophthalmol Soc > v.61(3) > 1144105

Lee, Kim, Kim, Paik, and Yang: Thelazia Callipaeda Infestation with Tarsal Ectropion

Abstract

Purpose

To report a case of Thelazia callipaeda infestation with tarsal ectropion.

Case summary

A 79-year-old man presented with epiphora and a sensation of a foreign body in his right eye that had persisted for several months. On the initial examination, he had conjunctival injection, conjunctival follicles, telangiectasia of the lid margins, meibomian gland dysfunction, and tarsal ectropion. We performed a lateral tarsal strip operation to treat the tarsal ectropion. During surgery, we identified and removed four parasites (about 1–2 cm in length and 0.5 mm in width) that had not been apparent on slit lamp examination. The parasites were identified as Thelazia callipaeda. The patient's symptoms sub-sequently improved considerably; he has followed up to the present time without recurrence.

Conclusions

In the presence of continuous extraocular inflammation, as with infestation by Thelazia callipaeda, ectropion can be induced by several possible causes. Involutional ectropion can be accelerated mechanically through rubbing. Other causes include inferior force from inflammation of the connective tissue and temporary blepharospasm.

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Figure 1.
Preoperative patient's clinical photographs. On the first visit, a 79-year-old man presented with ectropion, blepharitis on the right lower eyelid. (A) Straight ahead gaze. (B) Downgaze.
jkos-61-294f1.tif
Figure 2.
Intraoperative findings. (A) The removal of Thelazia callipaeda in conjunctival sac with forceps (arrow). (B) Parasites (arrows) found on the patient's eye.
jkos-61-294f2.tif
Figure 3.
Clinical photograph at postoperative 1 month. Photo shows significant improvement of blepharitis and ectropion on the right lower lid.
jkos-61-294f3.tif
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