J Korean Ophthalmol Soc.  2020 Mar;61(3):294-297. 10.3341/jkos.2020.61.3.294.

Thelazia Callipaeda Infestation with Tarsal Ectropion

• Lee YJ
• Kim SE
• Kim JH
• Paik JS
• Yang SW

• KMID: 2471771
• DOI: http://doi.org/10.3341/jkos.2020.61.3.294

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 subsequently 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.

Keyword

Tarsal ectropion; Thelazia callipaeda

MeSH Terms

Aged
Blepharospasm
Connective Tissue
Ectropion*
Foreign Bodies
Humans
Inflammation
Lacrimal Apparatus Diseases
Meibomian Glands
Parasites
Recurrence
Sensation
Slit Lamp
Telangiectasis
Thelazioidea*

Figure

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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.

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  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.

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  Figure 3. Clinical photograph at postoperative 1 month. Photo shows significant improvement of blepharitis and ectropion on the right lower lid.

Reference

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