There's a worm in my eye

OBJECTIVE: To report a case of an unusual worm infestation of the eye. CLINICAL FEATURES: A 28-year-old veterinary surgeon complained of the intermittent appearance of a worm in her eyes. Her previous camping travels in west and central Africa suggested the diagnosis of Loa loa, which was confirmed on surgical removal of the worm from beneath the conjunctiva. Laboratory investigations showed peripheral blood eosinophilia, negative thick blood film examinations for microfilariae and positive results of filarial serology. INTERVENTION AND OUTCOME: The worm was removed intact after incision of the overlying conjunctiva. Diethylcarbamazine was prescribed and the patient remained asymptomatic in the subsequent 12 months. CONCLUSIONS: The sighting of a worm in the eye is rare in Australia and usually occurs in immigrants or returned travellers. Loa loa is the most common offending species and is identifiable and treatable.