Ultrasound footage of tapeworm moving inside woman’s eye

A patient who reported to hospital with sudden-onset pain, redness and vision loss was found to have a live tapeworm in her left eye.

Writing in BMJ Case Reports, Dr Amar Pujari described how the 26-year-old woman had 20/20 visual acuity in her right eye and no perception of light in the affected eye.

Dr Pujari added that the patient did not have a history of trauma or ocular intervention.

He highlighted that conjunctival congestion and total corneal opacity in the left eye precluded anterior and posterior clinical examination of the eye.

B-scan ultrasonography of the posterior segment of the eye revealed a total retinal detachment with a subretinal cyst containing a “freely mobile, high-amplitude spike” —  suggesting the head of a live tapeworm.

“In view of hazy ocular media, no perception of light and risk of postoperative atrophic bulbi, surgical management was excluded and the patient opted for medical management,” Dr Pujari wrote.

Following four weeks of treatment with medication, the subretinal cyst partially collapsed and the tapeworm disappeared.

However, the patient continued to have no light perception in her left eye.

Dr Pujari highlighted that B-scan ultrasound is a quick and reliable tool for the assessment of retinochoroidal pathologies, particularly where clinical observation proves challenging.

“Patients with anterior segment media opacity may harbour significant posterior segment pathology,” Dr Pujari concluded.

Farah Gatrad, clinical and regulatory officer at the Association of Optometrists, shared with OT that this type of case is “extremely rare.”

Symptoms of an infestation would be apparent to the patient with most suffering from eye pain, irritation and vision disturbances, she added.

“If you have more severe symptoms, you may need to visit to your local Eye Emergency Department or A&E,” she emphasised.

Ms Gatrad concluded: “The eye is generally the secondary site of infestation by tapeworms in the larval form but they can be transmitted by eating raw or undercooked meat, drinking contaminated water or close contact with someone who has tapeworm.”

Image/Video credit: BMJ Case Reports 2018