Subconjunctival Loa Loa worm: case report

A 38-year old Ghanaian suddenly had the sensation of a foreign body in his right eye. Slit-lamp examination revealed a transparent worm underneath the conjunctiva. With topical anesthesia, the complete worm, 3.5 cm long, was removed surgically. A microbiological analysis at the Institute of Tropical Medicine confirmed the diagnosis of Loa Loa. Laboratory tests showed negative blood eosinophilia, positive blood film examination for microfilariae and positive results for filarial serology. The postoperative treatment consisted of progressive doses of di-ethyl-carbamazine (50-->100-->200 mg/d). A subconjunctival Loa Loa worm is rare in Belgium and usually occurs in immigrants or travellers returning from Tropical (Equatorial) West and Central Africa. Our patient visited Nigeria in 1985 and Ivory Coast in 1986. Those regions are highly endemic for Loa Loa.