CASE OF OCULAR SWELLING Dr M.L.Rokade MD,DNB. Deptt.Of Radiology,Jupiter Hospital,Thane,West.

CLINICAL HISTORY AND EXAMINATION FINDINGS 10 YRS OLD BOY ,COMPLAINTS OF PROGRESSIVE SWELLING ALONG THE MEDIAL ASPECT OF THE RIGHT EYE. MILD PAIN AND RESTRICTED MOVEMENTS ESPECIALLY LATERAL GAZE. ON EXAMINATION: FOCAL SWELLING AND REDNESS WITH SUBCONJUNCTIVAL MASS ANTERIOR TO THE MEDIAL RECTUS TENDON. MASS FIXED TO THE TENDON AS WELL AS SCLERA . NON MOBILE. NO TRANSILLUMINATION.

CLINICAL PHOTOGRAPH

ULTRASOUND Inflammatory changes CYSTIC SWELLING WITH ECHOGENIC MURAL NODULE ALONG THE MEDIAL RECTUS WITH ADJACENT INFLAMMATORY SOFT TISSUE. Inflammatory changes

DIAGNOSIS OCULAR CYSTICERCOSIS

CYSTICERCOSIS LARVAL FORM OF PORK TAPEWORM---TAENIA SOLIUM. HUMANS ARE INTERMEDIATE HOSTS. PIGS ARE DEFINITIVE HOST. CYSTICERCUS GETS ENCYSTED IN VARIOUS BODY TISSUES---EYES,CNS AND SUBCUTANEOUS TISSUES. ENDEMIC IN TROPICAL COUNTRIES: INDIA ,AFRICA,EAST ASIA.

OCULAR CYSTICERCOSIS MOST COMMON SUBRETINAL. IN INDIAN POPULATION: INTRAOCULAR AND EXTRAOCULAR CYSTICERCOSIS NOTED WITH EQUAL FREQUENCY. MAY CAUSE VISUAL LOSS IF SUBRETINAL OR COMPRESSES OPTIC NERVE. NO SEX OR AGE PREDILECTION.

WORK UP ← ULRASOUND MODALITY OF CHOICE FOR OCULAR CYSTICERCOSIS. USG: CYSTIC LESION WITH ECHOGENIC SCOLEX. MRI: TI-HYPOINTENSE CYSTIC LESION WITH HYPERINTENSE SCOLEX T2 - HYPERINTENSE CYSTIC LESION. CT:HYPODENSE MASS WITH HYPERDENSE SCOLEX. ELISA : ANTICYSTICERCAL ANTIBODIES. CBC: EOSINOPHILIA. ← T2W MRI SHOWING HYPERINTENSE CYSTIC LESION IN MEDIAL RECTUS

TREATMENT SURGICAL REMOVAL OF INTRAOCULAR CYST. MEDICATION: ALBENDAZOLE(BROAD SPECTRUM ANTIHELMINTH). FOLLOW UP SCANS FOR REDUCTION IN INFLAMATATION AND DISAPPEARNCE OF SCOLEX. References :RathS S,Honavar SG,Naik M etal.Orbital cysticercosis:clinical manifestations,diagnosis,management and outcome.Ophthalmology 2010 Mar:117(3):600-5.