Onchocerciasis syndrome (river blindness; onchocerca volvulus infestation)

General: Nematode infestation; positive diagnosis made with microfilariae from a skin bi 232f57c opsy and the presence of microfilariae in anterior chamber; infection results from the bite of the blackfly genus Simulium; recent findings suggest an autoimmune etiology for the occurrence of chorioretinopathy.

Ocular: Punctate keratitis (fluffy opacities); sclerosing keratitis; chronic iritis; pear-shaped pupil deformation; chorioretinitis; optic atrophy; uveitis; iris atrophy; papillitis; glaucoma; retinal degeneration; perivascular sheathing; microfilariae present in the anterior chamber, cornea, and vitreous; pannus; synechiae; cataracts; secondary glaucoma.

Clinical: Subcutaneous nodules; pruritus; atrophic skin changes; pretibial pigmentation; dermatitis; lymphadenitis.

Anderson J, Fuglsang H. Further studies on the treatment of ocular onchocerciasis with diethylcarbamazine and suramin. Br J Ophthalmol 1978; 62:450-457.

Fraunfelder FT, Roy FH. Current Ocular Therapy, 5th ed. Philadelphia: WB Saunders, 2000.

Hibberd PL, Ryan ET, Baker S. Pneumocystis carinii, parasitic infections and the eye. In: Albert DM, Jakobiec FA, eds. Principles and Practice of Ophthalmology, vol. V Philadelphia: WB Saunders, 1994:307l.

Meilof JF, et al. Autoimmunity and filariasis. Autoantibodies against cytoplasmic cellular proteins in sera of patients with onchocerciasis. J Immunol 1993; 151:5800-5809.

Neumann E, Gunders AE. Pathogenesis of the posterior segment lesion of ocular onchocerciasis. Am J Ophthalmol 1973; 75:82.

Roy FH. Onchocerciasis. Ann Ophthalmol 1974; 6: 12.