Wandering nematode in the vitreous cavity

Bancroftian filariasis is focally endemic in Egypt. There have been many reports of intraocular filariasis; the question of why one filarial nematode should cause ocular disease while another does not may be related to the behavior of the microfilaria and the location of the cross-reacting ocular antigen.

A 35-year-old woman with a white worm approximately 3 disk diameters in length penetrating the left macula, moving in the vitreous cavity, with a part of its length in the vitreous cavity while the rest was embedded subretinally, is described. Pars plana vitrectomy was performed and the worm was aspirated successfully.

Parasitologic study of the aspirated worm identified juvenile Wuchereria bancrofti. Ivermectin 150 μg/kg was given orally to the patient after identification of the worm. Six weeks later, the patient's visual acuity had improved to 20/200.

Intravitreal parasites should be surgically removed as soon as possible.