CONJUNCTIVAL CYSTICERCOSIS

ACTAO P H T H A L M O L O GVOL. I C A 46 1 9 6 8 Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi-5 ( I N D I A ) Institute of Ophthalnzology, Gandhi E y e Hospital Road, Aligarh. U . P. ( I N D I A )

CONJUNCTIVAL CYSTICERCOSIS BY

K . S. Mehra, H . V . Nema, 1. Nagarajachar, K. Rajyashree & A . H. Rahi INTRODUCTION

Ocular cysticercosis is quite a rare anomaly. In literature upto 1952 (Talkovskie) only 1200 cases of ocular cysticercosis had been reported and after that only 4 1 more cases have been added up in the literature. The sites for the lesion can be in the conjunctiva, orbit, lids and vitreous. Segal (1964) is of the opinion that it is much less frequent in anterior segment of the eye, palpebrae or the orbit. Taenia solium infection is quite common in Southern part of India. Ramalingham (1962) reported 17 cases of ocular cysticercosis out of which in 11 it was present in the anterior segment of the eye, while in Reddy’s series of 10 cases 8 had it in anterior segment of eye. Very recently Sen and others (1967) have reported 11 cases of ocular cysticercosis from South India - 10 cases out of these were situated subconjunctivally (Only 2 cases were attached to lateral rectus) while one was intravitrial. Uptill now only one case of ocular cysticercosis has been reported from North India (Gupta 1967) and that even had intraocular involvement. In total, 30 cases of anterior segment involvement of cysticercosis have been reported from India. While going through it, we noticed that in only 4 cases the conjunctival lesion was present on temporal side but none at the outer canthus otherwise in 26 it was present on the medial side. As in our case the lesion was at the outer canthus hence it is being reported. Received February 12th 1968. 980

CASE REPORT Patient named P. C. aged 13 years was admitted on 30th August, 1967 with the complaint of a swelling i n the right eye of one month duration which gradually increased in size (Figure 1). H e had no other complaints associated with it. RE 616 Vision LE 616 RE.: At outer canthus a circumscribed umblicated cystic swelling was present measuring about 12 mm X 17 mm in the 9 o’clock meridian lying deep to bulbar conjunctiva. Slight mobility of the growth was present in all directions. Conjunctiva over the growth was free. Tenderness was absent. Vascularisation over the mass was present. There was no restriction of movements of the eyeball and all other structures of the eye were normal. L. E. - N. A. D. INVESTIGATIONS Total WBC count 10,900lcmm P,, L 20, E 13 Urine NAD Stool NAD Mantoux Negative Night blood smear for Microfilaria: Negative Dental check up - NAD E.N.T. check up Hypertrophied tonsils present V.D.R.L. Negative X-ray orbit NAD

Fig. 1. Photograph of the patient shoving a mass at outer canthus.

981 Acta Ophthalmol. 46, V

65

Under general anaesthesia the mass was removed and it was found that is was not attached to sclera. Macroscopic examination: (Figure 2) A flask shaped mass present. The base of flask was about 1 cm in diameter while the head of the flask was 4 X 2 mm. The mass was hard to feel and a t places was covered with blackish tissue. On cutting it was noticed that the neck was solid mass of grayish tissue while in the base of the flask was a cavity of the size of 7 X 4 mm. This cavity contained a hard globular mass. There was a free space in between this hard mass and inner mass.

Fig. 2. Removed growth

Fig. 3. Showing coiled up appearance of cysticercosis cellulosae surrounded by a mantle of embryonic cells, chronic inflammatory cells and fibrous tissue (H and E X 80)

982

Fig. 4. Section passing through outer coat of the worm showing embryonic cells (H and E X 600)

Microscopic: Tissue consisted of a dead larva of highly tortuous body canal surrounded by a mantle of round cells, eosinophils and neutrophils (Figs. 3, 4, and 5).

SUMMARY

A case having conjunctival cysticercosis at outer canthus is being reported.

BIBLIOGRAPHY

A . N . and M a t h S. N.: Intraocular cysticercosis. Oriental Archives of Ophthalmology 5 : 115, 1967. 2. Ram.alingham T. T.: Proceedings of International Ophthalmological Conference, page 411, 1962. 3. R e d d y P. and Satyendran 0. M.: Ocular cysticercosis Amer. J. Ophth - 5 7 : 4, p. 664 - 1964. 1. Gupta,

983 65"

Fig. 5. Showing eosinophils and mono nuclears constituting outer mantle of the larva (H and E X 600)

4. Segal P., Mezygold S., Smolarz J.: Sub-retinal cystecercosis in macular region Amer. Jour. of Ophth., 57: 3, 655, 1964. 5 . S e n D. K., R. N . Mathur and A. Thomas: Ocular Cysticercosis in India - Brit. .Tour. of Ophth., . 51: 630. 1967. 6. Talkovskie S. J.: Oftalmogelmintosy, Moskva, Izdat. Cent. Int. Vsovierschenstoviv, Vratchei, 1952.

984