Granulomatous uveitis has traditionally raised concern for tuberculosis infection among patients seen in regional hospitals of South India. Many South Indian children with granulomatous anterior uveitis have received antituberculosis treatment, which has proven ineffective.1,5 Notably, these patients typically describe a strong temporal association between the onset of symptoms and having bathed in regional ponds or waterways. Recently, our histopathological study of affected ocular tissues suggested the presence of a trematode infection,1 which we have now identified as P varium. Snails act as the first intermediate host for this trematode in regional ponds, where they release cercarial larvae to infect the fish, which act as second intermediate hosts. Infected fish then transmit the trematode to birds.6 Fish-eating birds are the definitive hosts, while infected children become accidental hosts. Our data, together with the clustering of cases of granulomatous anterior uveitis in children from South Indian villages, suggest that trematode infection may be common in areas where fish and waterfowl infection is endemic.