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Subconjunctival Dirofilaria masquerading as nodular scleritis
  1. Saloni Sinha1,
  2. Shilpa Tarini2,
  3. Bhavik Panchal3 and
  4. Dilip K Mishra4
  1. 1Academy for Eye Care Education, L V Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
  2. 2Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
  3. 3Vitreoretina and Uveitis Service, LV Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
  4. 4Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Shilpa Tarini; tarinishilpa{at}


A man in his late 50s presented with a gradually enlarging, painless, reddish mass on the white portion of his left eye for 2 weeks. His best-corrected visual acuity was 20/20 in both eyes. Slit-lamp examination showed a congested, nodular, elevated lesion on the temporal bulbar conjunctiva with two pustule-like elevations. Anterior segment optical coherence tomography showed a subconjunctival solid mass rather than an abscess or a cyst. Scleral deroofing was performed and a long thread-like object resembling a dead worm was identified. The worm was removed intact, and its histopathology confirmed the diagnosis of Dirofilaria. Peripheral blood smear did not show any microfilariae. No recurrences or new lesions were observed during the follow-up examinations at 1 and 5 months post-surgery. This case highlights the importance of considering a parasitic aetiology in cases of nodular or infectious scleritis.

  • Infections
  • Tropical medicine (infectious disease)
  • Ophthalmology
  • Travel medicine
  • Doxycycline

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—ST, SS, BP and DKM. The following author gave final approval of the manuscript—ST.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.