Intraocular cilium masquerading as a parasite

Among the many different intraocular foreign bodies (IOFBs), eyelashes represent an uncommon finding almost invariably associated with a history of penetrating trauma. The authors describe a woman who had no signs and denied any history of trauma with an odd-looking, whitish, worm-like IOFB eventually identified by pathologic analysis as a cilium.

A 58-year-old lady complaining of floaters with mild loss of vision and redness presented to our institution. Slit-lamp examination revealed trace cells, while the fundus showed 1+ vitreous cells and the presence of a 3- to 4-mm-long, 0.3-mm-wide bright white "fluffy" wormlike object in the anterior vitreous. Medical history was unremarkable. The patient underwent pars plana vitrectomy with IOFB removal, and the specimen was sent for pathologic analysis that revealed the presence of a cilium encased in collagen fibers and mature adipose tissue. Vitreous cultures did not yield any pathogen.

Eyelashes as IOFBs have been described in several reports and are invariably associated with penetrating trauma. Intraocular cilia with no apparent history of trauma have been rarely reported. Our patient had a very peculiar presentation because of the "fluffy" bright white "capsule" that although readily visible resembled a parasite more than a cilium. The presence of adipose tissue at the base of the cilium that may have been dragged with the eyelash at the time of penetration is also a matter of speculation.