In a rare and alarming medical case from rural India, a 35-year-old man visited an ophthalmologist due to blurry vision, only to discover a live parasitic worm moving inside his eye.
The unusual case, recently reported in the New England Journal of Medicine, involved Gnathostoma spinigerum, a parasitic roundworm typically found in cats and dogs. This nematode is known to cause severe eye issues, including vision loss.
Worm ‘moving sluggishly’
Doctors suspect the worm entered the man’s body through the consumption of raw or undercooked meat and eventually made its way to the eye, where it was detected and treated. Experts noted that the physical examination of the man’s eye showed evidence of conjunctival injection, a sign of inflammation. Fundoscopic evaluation revealed a worm “moving sluggishly” in the posterior segment of the eye.
“Gnathostomiasis is acquired through ingestion of undercooked freshwater fish, poultry, snake, or frog in regions where the disease is endemic — the first two of which this patient from rural central India had consumed,” MedPage Today quoted the doctors as saying.
According to Abdhish Bhavsar, MD, a clinical spokesperson for the American Academy of Ophthalmology and a retina specialist at Retina Consultants of Minnesota, “Gnathostomiasis is one of several parasites that can infect the eye and the retina.”
“Some of these worms are larger, and some of them are smaller than others, and some of them are very small and can travel within the retina or subretinal space under the retina, and can cause significant damage to the eye and to the vision or even potentially cause blindness.”
The doctors carried out a pars plana vitrectomy (PPV) to successfully extract the worm from the eye. “Under light microscopy, a larval-stage nematode with a cephalic bulb, thick cuticle, and well-developed intestine was identified; these features were consistent with Gnathostoma spinigerum,” the doctors said.
Pars plana vitrectomy (PPV) is a surgical technique used to manage a range of conditions affecting the retina and vitreous. The procedure includes removing the vitreous gel, a clear, jelly-like substance that occupies the central part of the eye, in order to access the retina and other internal structures at the back of the eye.