Loa loa in the vitreous cavity of the eye

A 25-year-old man presented with painful diminution of vision (20/160), accompanied by redness, pain and floaters, over a period of 2 weeks, in his left eye. On examination, the anterior segment revealed moderate inflammation. Posterior segment examination showed a grade one vitreous haze with a fairly long live worm moving around in a haphazard and relentless manner throughout the vitreous cavity. The media was slightly hazy due to corneal oedema. The worm was clearly visible in the fundus photo taken. So we planned the patient for vitrectomy, and removal of the worm was performed under steroid cover. The worm was sent to the microbiology department for examination and it was found to be the species of Loa loa. The patient was administered a course of diethylcarbamazine and, on follow-up after 2 weeks, his vision had improved to 20/40.