Uveitis-glaucoma-edema (UGE): a clinical triad in un-treated helminth-associated severe anterior segment inflammation

To describe the clinical presentation, treatment response, and surgical management of anterior segment ocular helminthic infections.

This single-center case series included patients diagnosed with helminthic anterior uveitis based on the presence of a characteristic triad: anterior uveitis, elevated intraocular pressure (IOP), and corneal edema. All patients were initially treated with topical corticosteroids and antiglaucoma medications. Definitive treatment consisted of surgical extraction of the intraocular helminth after adequate control of inflammation and IOP.

All cases presented with Uveitis, raised IOP (Glaucoma), and corneal Edema (UGE) triad, which significantly impacted initial visualization and diagnosis. A non-touch surgical technique using viscoelastic-assisted dissection and capsulorhexis forceps was employed to extract the intraocular worms. Microscopic identification confirmed the organisms as Gnathostoma spinigerum, Wuchereria bancrofti, and Loa loa.

Helminthic infestation of the anterior segment, although rare, may present as a distinct clinical entity characterized by uveitis, secondary glaucoma, and corneal edema. Early recognition of this triad can raise clinical suspicion. Controlled inflammation and IOP normalization, followed by non-traumatic surgical extraction, are key to favorable outcomes.