The epidemiology of ocular toxocariasis

Ocular toxocariasis damages vision and may cause blindness. It is a relatively 'new' disease, the histological changes having been described in 1950 and the causative organism identified in 1956. Many aspects of the epidemiology of toxocariasis are unclear. It is generally accepted that the usual route of entry to the eye is via the blood stream. Once the eye is invaded characteristic changes are produced with comparative sparing of the anterior segment. Species differences in susceptibility can be very marked. In Mongolian gerbils 55% of infected animals exhibit ocular lesions. Humans are fortunate in that they are far less susceptible to ocular infection. While it has been established that ocular toxocariasis is caused by Toxocara canis, the role of T. cati in this condition is still unclear. It is perhaps surprising that the prevalence of such a disease in humans should remain in doubt. However, the wide variation in the few estimates of prevalence may well be a reflection of the wide variation in exposure as evidenced by the wide variation in seroprevalence. A further factor mitigating against an identification of prevalence rates is the fact that the condition is usually unilateral. Most surveys of blindness stipulate a vision of 6/60 or less in the better eye and so toxocariasis cases go unrecorded. There is a need for surveys which identify the level of vision in both eyes.