A Man With Unilateral Ocular Pain and Blindness - QUIZ

A 25-year-old black man with unknown medical history presented at our ophthalmologic mobile outpatient clinic (District of Sankuru, East Kasai Province, Democratic Republic of Congo) with blindness and pain in his left eye. The examination showed a shrunken, nonfunctional left eye (phthisis bulbi), nonreactive to light, which, by slit lamp exam, revealed a large, blackish, crescent-shaped, worm-like foreign body wedged into the angle of the anterior chamber (Figure 1).

Much to our surprise, the foreign body began a peristaltic motion upon physical stimulation of the eye. The patient was otherwise in good health and free of general symptoms. Physical findings were unremarkable; thus, no further diagnostic tests were performed. The parasite was removed under local anesthesia, still alive and crawling (Figure 2). It was sent to the Hungarian Natural History Museum, Budapest, for further identification. The patient often consumed poorly cooked snakes. Despite the surgical procedure, the patient permanently lost vision in the left eye. 

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Clinical Infectious Diseases 2013;57(3):418

DOI: 10.1093/cid/cit309