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RNA Interference in Ticks
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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
PubMed
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.

Keywords:
Deer tick larvaIxodes scapularis larvaOcular attachmentTick conjunctival attachment

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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.