Ocular Parasitic Infestation Secondary to Raw Fish Consumption

Abstract

We report a case of ocular parasitic infestation involving anterior chamber and bilateral retina in a patient who enjoys consuming raw fish regularly. A healthy 62-year-old gentleman, presented with sudden onset of right eye reduced vision. On examination, his right eye visual acuity was 6/12 and left eye was 6/6. Right eye anterior chamber noted two thread-like tapeworm hanging over the pupillary edge at 3 and 5 o’clock. However, there was no inflammation seen in anterior chamber. Upon dilated fundus examination, the presence of parasite inferior to the macula was found in both eyes. Optical coherence tomography(OCT) macular showed right eye epiretinal membrane and we were able to observe the cross section body of the parasite. The left eye OCT macular was normal. There was no intraretinal or subretinal fluid observed in both eyes. Bilateral eye laser photocoagulation surrounding the parasite was performed. He was started on oral albendazole 400mg once daily for 2 months. Topical steroid 4 times a day over his right eye was prescribed for 2 months as well. He was advised to stop consuming raw fish. After completed the treatment, his vision remained the same. Anterior chamber tapeworms resolved, and no new parasitic lesions were seen in the retina. The epiretinal membrane on the retina persisted, however, patient refused any intervention for now.One of the biggest risks associated with consuming raw fish is parasitic infestation in the eye. Public education and prompt treatment should be given to prevent blindness that could be resulted from ocular parasitic infestation.