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Management of Subconjunctival Dirofilaria repens

Jean-Jacques Gicquel, MD; Jacques Berthonneau, MD; Laurent Curutchet, MD; Bertrand Hue, MD; Paul Dighiero, MD, PhD
Arch Ophthalmol. 2004;122(3):416. doi:10.1001/archopht.122.3.416.
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We report the case of subconjunctival localization of Dirofilaria repens (Figure 1)in a 40-year-old African man, born in Abidjan, Ivory Coast, who had livedthere until he moved to Poitiers, France, 2 years before he was examined byus. He had been symptomatic for less than a week. Surgical extraction (Figure 2) allowed the identification of anadult Dirofilaria repens.

Figure 1.

Slitlamp examination shows a large-diameterworm that is animated with slow movements.

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Figure 1.

Slitlamp examination shows a large-diameterworm that is animated with slow movements.

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Figure 2.

To avoid harming the parasitewith a needle and because the patient was not very compliant, surgical removalof the parasite was performed with the patient under general anesthesia. A,A conjunctival incision is performed close to the worm, taking care not toharm it, as anaphylactic shock may occur if the worm is ruptured.1 B, A polishing nozzle is used to gently pull outthe parasite. C, A second nozzle helps to roll up the worm in a "spaghetti"fashion. D, Finally, the entire parasite is removed and sent to the NationalMuseum of Natural History, Paris, France, for taxonomic identification.

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