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Deer tick masquerading as pigmented conjunctival lesion
Robin K Kuriakose1, Lorna W Grant2, Eric K Chin3
1Virginia Commonwealth University School of Medicine, 1201 E. Marshall St., Richmond, VA, USA.
American Journal of Ophthalmology Case Reports
|March 6, 2018
Summary
A rare case of a black-legged deer tick (Ixodes scapularis) penetrating the conjunctiva is presented. Prompt ophthalmologic evaluation and tick removal are crucial for ocular surface tick adherence.
Area of Science:
- Ophthalmology
- Parasitology
- Infectious Diseases
Background:
- Conjunctival tick adherence is an infrequent occurrence.
- Few documented cases exist in medical literature.
Observation:
- A patient presented with unilateral ocular pain, decreased vision, and a pigmented lesion.
- Slit lamp examination revealed a tick attached to the conjunctiva.
- Pathology confirmed the insect exoskeleton, likely a larval black-legged deer tick.
Findings:
- The tick was identified as a probable larval Ixodes scapularis.
- The patient experienced symptoms for three weeks.
- Treatment included topical antibiotics and anti-inflammatory drops.
Implications:
- Immediate ophthalmologic consultation and prompt tick removal are recommended for ocular surface tick penetration.
- Prophylactic doxycycline was administered due to endemic Lyme disease risk.
- Adherence to Infectious Diseases Society of America guidelines for prophylaxis is advised.
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