OPHTHALMIC CYSTICERCOSIS

Recently I researched and presented to a class of undergraduate students concerning the topic of Ophthalmic Cysticercosis. I felt obligated to share this information regarding the complications associated with the consumption of undercooked pork. The presentation went rather well and feedback from students, as well as the professor was rather inspiring. Enjoy!

•Ophthalmic Cysticercosis
by H. Ronnie Nelson II

What is ophthalmic cysticercosis?

•An infection in and around the ocular organs caused by Taenia solium (the pork tapeworm). The Infection occurs when the tapeworm larvae enter the body and form cysticerci. When cysticerci are found in the brain, the condition is called neurocysticercosis

Scientific Classification

•Kingdom: Animalia

•Phylum: Plathelminthes

•Class: Cestoda

•Order: Cyclophyllidea

•Family: Taeniidae

•Genus: Taenia

•Species: Taenia Solium

Transmission to humans 

Humans are the intermediate hosts for T solium, and pigs are the definitive hosts. A tapeworm larval cyst (cysticercus) is ingested with poorly-cooked infected pork. The larva escapes the cyst and passes to the small intestine, where it attaches to the mucosa with scolex suckers. Egg-containing proglottids develop as the worm matures in 3-4 months.

The adult worm may live in the small intestine for as long as 25 years without symptoms. When the primary larvae (oncospheres) penetrate the intestinal mucosa, the Larvae enters into the circulatory system spreading to the Neural, muscular, and ocular tissues of the human body.

•Symptoms

•Nausea

•Week Muscles

•Loss of Weight

•Malnutrition

•Abdominal Pain

•Passing worm sections in stool

Ophthalmic Cysticercosis can affect ALL ocular Tissue including:

•Vitreous cavity

•Subretinal tissue

•Conjunctiva

•Extraocular muscles

•Optic Nerve

Damage to these areas can result in the following:

•Cataract formation

•Iritis

•Severe Headache

•Strabismus

•Diplopia

•Severe redness

•Proptosis

Facts about Ophthalmic Cysticercosis…

•A LIVE cyst may be freely mobile inside the anterior chamber or attached to an ocular structure surrounded in a bed of inflammation.

•Cyst death causes the release of TOXIC products also resulting in severe inflammation.

•Cases with intense inflammation may prevent the cyst from being clinically visualized by ocular and neural imaging technology.

•Cysticercosis affects an estimated 50 million people worldwide.

• Ocular cysticercosis is endemic in tropical areas, such as sub-Saharan Africa, India, and East Asia. Other endemic areas include Mexico and Latin America.

•There is a correlation between new diagnosed cases in the U.S. and immigration increases from endemic areas.

•An estimated 1000 new cases per year are diagnosed in the United States.

•There is no statistical evidence showing diagnosed cases being related to race, sex, or specific to one eye.

•Ocular Cysticercosis is more commonly reported younger age groups.   

Treatment

•Surgical removal is required in individuals with intraocular cysts.

•Deep orbital dissection in conjunction with difficulty in completely excising/removing the cyst because of the surrounding inflammatory response increase the chances of postoperative complications.

•Cysts deep within the orbit are best treated conservatively with a 4-week regimen of oral albendazole (Benzamidazole) in conjunction with oral steroids/corticosteroids in a tapering dose over a 1-month period.

•Resolution of the cyst may take from a few days to months depending on the density of the surrounding inflammation. Based on the individual’s response to medical therapy, another course of medication may be required.