[Ocular cysticercosis]

Ocular cysticercosis results from development of Taenia solium larvae, Cysticercus cellulosae, in the eye. This condition is observed all over the world but is particularly common in developing countries. The eye, like nervous system and muscle tissue, is a prime location for parasitic development because of its rich vascularization. Intraorbital cysticercosis accounts for 75 to 85% of cases and if untreated leads to blindness. Intravitreal involvement is the most common followed by subretinal involvement. Involvement of other structures such as the camera aqueosa, iris, and crystalline lens is rare. Diagnosis of intraocular cysticercosis is straightforward when cysticerci are visible. Immunologic testing of aqueous humor using ELISA, western-blot, or immunodetection of circulating antigens can be useful diagnostic techniques in patients with opacification of the eye. Involvement of the orbit, palpebra, conjunctiva, and lacrimal glands is observed in 20 to 25% of cases. Diagnosis of adnexal involvement is facilitated by ultrasonography and CT-scan. Drug therapy for ocular manifestations of cysticercosis is ineffective and hastens progression of the disease by exacerbating the inflammatory response. Surgical treatment is the only alternative. Significant progress has been made thanks to new microsurgical vitreal and retinal procedures but these techniques are often unavailable in developing countries. The severity of ocular cysticercosis and poor management facilities in developing countries underlines the need for prevention by sanitary measures and health education.