Related Experiment Video
Updated: Mar 24, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Unilateral phthiriasis palpebrarum infestation in a child during occlusion therapy for amblyopia: Case report
Elif Demirkilinc Biler1, Ozlem Barut Selver1, Melis Palamar1
1Ege University, Department of Ophthalmology, Izmir, Turkey.
Insights
Phthiriasis palpebrarum, or pubic lice on eyelashes, can affect children undergoing occlusion therapy for amblyopia. Proper hygiene of eye patches is crucial to prevent such infestations, which are not always indicative of sexual abuse.
Area of Science:
- Ophthalmology
- Parasitology
- Pediatrics
Background:
- Phthiriasis palpebrarum, an infestation of the eyelashes by pubic lice (Pthirus pubis), is rare in children.
- It can be associated with sexual abuse, but alternative transmission routes should be investigated.
Purpose of the Study:
- To report a case of phthiriasis palpebrarum in a child using occlusion therapy for amblyopia.
- To discuss the differential diagnosis and transmission routes, emphasizing hygiene in occlusion therapy.
Main Methods:
- Clinical examination of an 8-year-old boy with itchy, burning eyes.
- Parasitological examination of eyelash samples to confirm lice and nits.
- Familial evaluation for additional infestations and psychiatric assessment for abuse.
Main Results:
- Lice and nits were identified on the eyelashes of the boy's occluded eye.
- The father had genital phthiriasis pubis.
- No signs of sexual abuse were found; transmission was likely due to adhesive patch misuse.
Conclusions:
- Phthiriasis palpebrarum in children necessitates exclusion of sexual abuse.
- Parents of amblyopic children on occlusion therapy must be educated on patch hygiene to prevent infections and infestations.
Abstract:
An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at his right eye for 10 days. He was on full time right eye occlusion therapy for left amblyopia. Slit lamp examination revealed nits and adult lice anchored to the eyelashes in his occluded eye. Eyelashes and all detected lice and nits were mechanically trimmed, and sent for parasitological examination, which confirmed the diagnosis. Upon familial evaluation for additional infestation, the father was also found to have genital phthiriasis pubis and received appropriate treatment. While phthiriasis palpebrarum in children may signify sexual abuse, a detailed investigation by a child psychiatrist was performed and revealed no sign of abuse. Since the infestation was at only on occluded eye, the most possible explanation for the transmission was evaluated as the misusage of the adhesive patch in our case. In conclusion, sexual abuse should be excluded in children with phthiriasis palpebrarum and parents of amblyopic children on occlusion therapy should be warned about the importance of the hygiene of the patching in order to avoid any kind of infection and infestation.
