Be able to invade our country and its diagnosis and treatment of the human eye worm
Author: Han the East China Sea, Feng
own country, Han Huilin
【Abstract】 Objective To investigate the invasive nematode
species of China's human eye and its diagnosis and treatment for eye worm disease prevention and treatment of clinical information provided. Methods based on since the founding of China's medical parasitology research published theory, research papers, etc., in accordance with clinical medicine, preventive medicine, the practical needs, from important types, prevalence, it is important hosts, parasitic eye stage, invasive eye channels, pathogen morphology, eye damage, diagnosis and treatment, the brief introduction to the human
eye worm invasion of our country and treat the disease. The results of this paper, the parasitic nematodes in our country's 11 species of the human eye, except a very few types of natural infection in the country has not yet beyond the
rest of China have a natural epidemic; invasive stage of the human eye, mostly parasitic larvae, a small number of adults. Conclusion China's vast territory, large population, may be parasitic on the human body are more types of parasites. With the development of medical science, or intrusion into the eyes of the parasite will continue to be discovered. Due to many constraints, this review may not include the newly discovered species. This article is intended to serve as a catalyst in order to arouse the concern of colleagues in order to promote prevention and treatment of eye diseases.
Key words Eye worm disease; nematode; treatment
Nematodes belonging to Nemathelminthes, Nematoda and
variety, most of the business self-life, a small number of
parasites in humans and animals, causing the corresponding worm disease, in which a small number of species can affect human and animal eyes, causing eye worm disease.
In our country can invade the human eye there are dozens of species of nematodes, parasitic, which specializes in the
type of eye is not much, so the vast majority of parasitic nematodes are ectopic. As clinicians, lack of knowledge of the diseases, so that affected the correct diagnosis and treatment for patients bring more pain and suffering. Author based on
the relevant literature, will be able to hit the human eye in our country and its diagnosis and treatment of C. elegans are summarized as follows, for clinical workers.
A nematode roundworm class
Yamaguti (1961) the roundworm C. elegans class (not
including the Sharp-tailed type nematodes) were divided into 4 families, 11 subfamilies, 60 genera, a total of more than 500 kinds of [1]. Multi-class adult mammal parasites on human and animal intestines, in which even certain types of larvae can
feed on the human eye, causing eye roundworm larva disease. The more important for the following.
1.1 people roundworm larva Wei Ren roundworm (Ascaris lumbricoides like) larvae.
1.1.1 The prevalence of adult parasites in the human
small intestine, can cause human ascariasis. Pest was widely distributed in China, most parts of the higher rate of infection is one of the most common human parasites. 1988 to 1992, according to China's first nationwide survey of human parasite infection data show that insect infection rate of 47% of the total, it was estimated there are 5.3 million people infected, about the world 41% of the total number of infections [2] .
1.1.2 Important host definitive host: human.
1.1.3 The stage of parasitic worms in the eyes of the third and fourth stages of larvae.
1.1.4 Eye invasive means of (1) With the blood
circulation to the eye into the retina retinal artery perforation; (2) can also be through the nasopharynx, nasal cavity, nasal lacrimal duct into the lacrimal sac.
1.1.5 pathogenic form of the larvae form of the information described in rare, accounting for Yu Tang Chinese scholars (1958) has reported that out from the eyes of the roundworm larvae of linear, milky white, body length of about
2 mm; but there are large parasites persons, Wu Hua (1986) had from one cases of 6-month-old baby taken out a long-lacrimal
duct 6.5 cm, a diameter of 1.2 mm of the roundworm larva.
1.1.6 eye damage caused by roundworm larvae invade the
eye eye ascariasis. Parasites invade lacrimal, lacrimal sac, which can cause itching, tearing, mobile flu (crawling feeling), and inflammation; invasive subconjunctival cause conjunctivitis; invade the retina, choroid inflammation caused by the corresponding reactions. When the invasion when the fundus, causing vision loss.
1.1.7 Diagnostics (1) Clinical diagnosis: can an infected person's age, occupation, eye symptoms, medical history by asking the initial diagnosis, if the patient addition to local
inflammation, there are more mobile flu diagnosis . (2) Etiology Diagnosis: When the parasites on the tear ducts, they can see the exposure of the parasites through the investigation confirmed.
1.1.8 Control (1) Note that food hygiene to prevent
infection is the key to prevention of this disease; (2) parasites invade lacrimal passage, and sometimes a small point in the lacrimal exposed parasite, the symptoms disappeared after clamp removal; (3) symptomatic treatment .
1.2 dog roundworm Toxocara larva of dog (dog roundworm) larvae. Adults parasitic in mammals, carnivorous animals the small intestine. Roundworm larvae can invade the human eye or other tissues and organs, the cause eye or other parts of Toxocara canis disease.
1.2.1 The prevalence of this worm was a worldwide distribution, a place where dogs have their infection reported. My distribution is very broad, since the 20th century, 20 years since there are dogs around the infected one
after another reported, but reports of human infection are
relatively small.
1.2.2 Important host definitive host: dogs, cats, wolves, foxes and other animals. Men are not the normal host of this pest.
1.2.3 parasitic larvae stage of the eye in four phases, parasitic in the human eye and the larvae within the
organization more in their second or third.
1.2.4 intrusive means of the eye may be pierced with the blood circulation into the retina retinal artery, but also through the nasopharynx, nasal cavity, nasal lacrimal duct
into the lacrimal sac.
1.2.5 pathogenic form of the second and third larvae of linear, milky white, size 370 ~ 934 μm.
1.2.6 eye damage can cause the larvae invade the eye anterior chamber, ciliary body, cornea, retina, optic nerve, choroid and vitreous abscess and other inflammatory; the worm
often can cause optic nerve stimulation, the formation of granulation macula, etc. swelling; result of the disease often accompanied by chronic endophthalmitis, retinal detachment, and granulomatous lesions, it would often clinically
misdiagnosed as the disease while the line of retinoblastoma enucleation surgery, leaving life-long harm to patients.
1.2.7 methods of diagnosis (1) Clinical diagnosis: asking patients Kennel history, personal food hygiene practices, the recent availability of fever, with or without respiratory symptoms, and then look around the availability of the pupil in patients with "white pupil" phenomenon (which is the pest the formation of granuloma lesions), may thus be speculated that diagnosis. (2) Laboratory diagnosis: In the tear ducts when the parasite can be used a magnifying glass to observe parasite diagnosis; while in other parts of the parasite used slit lamp, ophthalmoscopy, or immunological tests such as a comprehensive diagnosis.
1.2.8 Control principles (1) to strengthen the source of infection, such as dogs, cats and other animals, treatment,控
制传染源, bearing in mind the food hygiene to prevent
infection; (2) treatment more difficult, if the use of drugs to kill parasites, may cause eye tissue reaction to the poor
prognosis of visual acuity; also many not be used surgical method to restore eyesight.
2 conjunctival sucking nematode (eye worm)
Insect pest in the zoology category under SPIRURIDA, sucking Branch, sucking is, for a class of obligate parasites
of parasites on the eye. Such kinds of large insects, according to the former Soviet Union scholar screw yabin (1949) has been described in 33 species, 13 species have been found in China (Nai Nan 1975) [3]. Most of them are parasitic
on mammals, birds and other animals of the tear ducts, instant film or conjunctival sac, the parasites in the human eye are conjunctival sucking sucking nematode worm, and California two kinds. Human infections in our reports are all run conjunctiva
sucking worm. Insect parasites in the human and animal eyes, causing thelaziasis.
2.1 The prevalence of conjunctival thelaziasis mainly in Asian countries, and therefore, "the Oriental eye worm," said. China's 25 provinces and autonomous regions of human infection
have been reported. The main source of infection for the insect dog, followed by domestic cats and other animals, such as Wang Zeng-yin, is equal to 1982 and 1991, check the Anhui Huaibei area 305 of the dogs, infection rate was 76.7%, of
which five rivers, and some villages, homes Sixian All infected dogs [3]. China's current population of the infection, the lack of detailed information, from the scattered reports of view, infected mostly children, in rural areas than urban.
2.2 Important host definitive host: and the dogs, cats and other animals. Intermediate host: Okada flies around the eyes.
2.3 The stage of parasitic infection in the eye of the larvae, larva, adult.
2.4-invasive means of eye infection when the larvae of
flies containing smoked eye secretions of humans or animals, the larvae infected with invasive eyes.
2.5-pathogenic form (1) adult: parasite linear, milky white, male and female variant, size of 4.5 ~ 23 mm × 0.25 ~
0.85 mm. (2) larvae: In order to ovoviviparous from the adult directly produced in the host eye. Larvae filamentous, milky white, size 350 ~ 414 μm × 13 ~ 19 μm.
2.6 Multi-parasitic adult eye damage to the eye on the vault at the Department of outer canthal can also be parasitic
in the anterior chamber, lacrimal duct, lacrimal gland, eye conjunctival sac, etc., causing itchy eyes, tearing, eye pain, photophobia, secretions increased and so on, were also re-
emerged conjunctival hyperemia, swelling, inflammation, and even the formation of local small ulcers, etc.; if the parasite in the anterior chamber, the patient consciously immediate sense of filamentous moving shadows and parasites, and accompanied by aqueous turbid, eye pressure is increased, ciliary congestion, decreased vision and other symptoms;
severe cases can cause tissue damage, granuloma formation, fibrosis, scar formation, corneal opacity, eyelid eversion and so on.
2.7 methods of diagnosis (1) According to the season, eye foreign body sensation, clinical manifestations such as
diagnosis, symptoms such as eye foreign body sensation for several days, more than more valuable. (2) to find pathogens: with the naked eye or a magnifying glass to identify the adult in the eye directly confirmed; sterile cotton swab can also be
used to take eye secretions, set out the microscopic examination confirmed the larvae. (3) Drug insecticide France: The 2% of the cocaine or 1% tetracaine eye drops a few drops in the eye drops, 2 ~ 5 min after the parasite stimulated climbing or with tears flowing out of shape under the parasite diagnosis .
2.8 Control principles (1) to strengthen the source of infection, such as dogs, cats and other animals, treatment,控
制传染源to prevent transmission; people (especially children) to keep the eyes clean, to prevent the flies bite suction eye secretions and the prevention of this disease important
measures; (2) treatment: Available direct access worms law, drug de-worming and France (with diagnosis), as long as the parasites were removed, the symptoms disappear naturally.
3 immitis
Filarial a wide range of now there are 537 kinds of
records [1]. Wide range of parasitic in birds, mammals, reptiles and amphibians, of which very few parasites to humans. The filarial classification, scholars disagree. Levine (1968) will be vested in filarial filarial class sub-orders,
filarial General Division. The Section has close ties with the people and animals 9 subfamilies, 28 genera, to parasitic in humans, 5 genera, 8 species [1]. Can invade the eye caused by ocular filariasis, there are at least five kinds of.
3.1 Ban's Wu Ce nematodes (Wuchereria bancrofti) and normal parasite Wuchereria bancrofti in the human lymphatic system, causing Bancroftian filariasis. Adult, larvae (microfilaria) even feed on the eye, causing eye Bancroftian filariasis.
3.1.1 Prevalence in 1997, according to World Health Organization data show that the disease were prevalent in 72 countries, including Asia, Africa and more serious. Popular in north China's Shandong Province to the south of 15 provinces, autonomous regions and municipalities of the 864 counties (not including Taiwan Province), of which 181 for Wuchereria bancrofti and Malay mix filariasis endemic area (according to 1980 administrative divisions), according to information in the fight against the former is estimated that a total of
21.962 million people filariasis patients, after years of control, to 1994 (including Brugia malayi) all meet the basic criteria for elimination.
3.1.2 Important host definitive host: human (only); intermediate hosts: mosquitoes, a vector of the disease in
China there are three kinds of mosquitoes 10 species.
3.1.3 parasitic adult stage in the eyes, the larva.
3.1.4 Eye of the way to invasion of the larvae may be infected with lymphatic vessels from the eyelids and so
shallow to a deeper lymphatic vessels, and then pleasant to the eye for the growth and development within the adult; it may be the ciliary body blood vessels enter the eye through the posterior chamber, and then moved into the anterior chamber develop into adults, and can output microfilaria.
3.1.5 pathogenic form (1) adult: parasite slender, shaped like cotton, milky white, male and female variant. Size of 28.2 ~ 105 mm × 0.1 ~ 0.8 mm. (2) microfilaria: direct output from the females, its shape is filamentous, Wai Pi sheath,
colorless and transparent, the size of 224 ~ 296 μm × 5.3 ~
7 μm.
3.1.6 eye damage, according to case reports indicate that: Wuchereria bancrofti adults and larvae feed on the anterior chamber and the eyelids, etc., anterior chamber
microfilaria can be seen in the water. The worm stimulation and the role of metabolites can cause local tissue inflammation, inflammatory granuloma, optic disc hyperemia, retinal edema. Patients may have blurred vision, shame-ming,
tearing, eye pain, headache and other symptoms, severe visual impairment can occur, and even blindness.
3.1.7 Diagnosis of ocular filariasis on account of limited diagnostic methods, according to the performance of patients with ocular symptoms, with or without hyperlipidemia,
as well as filariasis microfilariae immunological tests such as whether the positive preliminary diagnosis; invade surrounding tissue for the eyes, anterior chamber, ocular inspection of the parasites, etc. can be directly observed or
slit-lamp fundus microscopy confirmed; also check the room through the water microfilaria confirmed.
3.1.8 Control Principles (1) Prevention: Through survey and treatment控制传染源, mosquito mosquito control to prevent mosquito bites and other measures to prevent transmission of infection. (2) treatment: For the parasites on the eyelids, conjunctiva, anterior chamber, sclera, etc. of the parasites, using surgery to take a good insect treatment, due to a larger parasite, easy to identify and take insects.
3.2 Brugia malayi (Brugia malayi) and normal insect parasitic in the human lymphatic system, even parasitic in the
eye, causing eye Malay filariasis.
3.2.1 The distribution of the prevalence of Brugia malayi is limited to Asia, China, Japan and other 12 countries, its prevalence is much smaller than the region Wuchereria bancrofti.
3.2.2 Important host definitive host: human. Intermediate hosts: mosquitoes, a vector of the disease in our country there are 3 of 9 species.
3.2.3 parasitic adult stage in the eyes, the larva.
3.2.4 invasive way to classmate's eye immitis.
3.2.5 Pathogen morphology and Wuchereria bancrofti are similar, but slightly smaller, slim. Adult slender, shaped like cotton, milky white, male and female variant. Size 20 ~ 62 mm × 0.07 ~ 0.224 mm. Microfilariae by female direct output, filamentous, Wai Pi sheath, colorless and transparent, the size of 177 ~ 230 μm × 5 ~ 6 μm.
3.2.6 the other eye hazards, diagnosis, prevention and other basic principles of classmate's immitis.
3.3 Ah-Ah-nematode (Luo Asi insects or Africa Euglena) attached to the Luo Asi insect genera, the genus has been found there are six kinds, in addition to Luo Asi insects feed on the human body, the other a few are parasitic in primates. Normal adult insect parasites in the human subcutaneous tissue caused by Ah-filariasis, also can invade the eyes causing eye Ah filariasis.
3.3.1 The prevalence of this disease occurs mainly in tropical rain forests of Africa region in recent years with frequent international exchanges, foreign aid workers returning from Africa, the commonplace and there Luo Asi
infected insects, such as the First Military Medical University in foreign aid officers found 14 cases of this disease (Lee Fukuyama 1986). Zhejiang People's Health Center in 1978 reported, 62 (1975) and 162 (1977) returned in foreign
aid, respectively, in 3 cases and 8 cases of hyperlipidemia were Ah microfilaria in 60 mm3 the number of microfilaria in the blood of up to 1632 Article [4].
3.3.2 Important host definitive host: human. Paul insect host: In natural conditions, the existence of Paul Luo Asi pest insect host is not yet determined, but under the experimental conditions, the majority of primates can be used as its host insect protection. Intermediate host: Chrysops, type more, mainly for points and static Chrysops Chrysops.
3.3.3 invaded the stage of eye adult microfilariae may invade the eye, the harm caused mainly by the adult.
3.3.4 invasive means of eye plaque containing the infective stage larvae of blood-sucking fly bite, the larvae
invade the body through the skin and subcutaneous tissue in the development of the adult. Adult migration in deep tissue, can invade the eye parasitism. Parasites may be a subcutaneous skin along the nasion transfer to another eye.
3.3.5 pathogenic form (1) adult: parasite linear, milky
white, male and female variant. Size of 25 ~ 70 mm × 0.3 ~
0.55 mm. (2) microfilaria: direct outputs from the females.
Filamentous, Wai Pi sheath, colorless and transparent, the size of 250 ~ 300 μm × 6 ~ 8.5 μm.
3.3.6 damage to the adult eye often migrating in the eyelid skin, bulbar conjunctiva, cornea, the anterior chamber and other parts, causing severe conjunctivitis disorders, eye edema and bulbar conjunctiva granuloma. In the eyelid skin parasites, it often can be seen wavering mass, there is a sense of tension and pain. When the invasion of bulbar conjunctiva, the local appears congestion, edema,
inflammation, patients have itching, crawling dynamic, tears, shame-ming, pain and other symptoms, but little effect on vision. Reposted elsewhere in the paper for free download http://
3.3.7 methods of diagnosis (1) Clinical diagnosis: Check whether the patient body surface occurs Calabar swelling, eye whether the abnormal performance; specifically asked whether in the endemic areas in patients with work history, living history, travel history, etc. can be made a preliminary diagnosis. Due to our epidemic of the disease-free, all found
in patients, are in foreign aid returned to find personal information on the diagnosis of this disease has a significant value. (2) Etiology Diagnosis: can be from blood, tumor tissue fluid in the detection of microfilaria make a preliminary
diagnosis; best to surgery from the eyelids, conjunctiva and eye swelling around the subcutaneous tissue of the migratory remove adult diagnosed.
3.3.8 Treatment for the parasite in the eye and the skin