Clinico-demographic profile and management outcomes of periocular and subconjunctival dirofilariasis in South India.

[PURPOSE] To report the clinico-demographic profile and management outcomes of periocular and subconjunctival dirofilariasis.

[DESIGN] Retrospective observational study.

[SETTING] Institutional study.

[METHODS STUDY POPULATION] Seventy patients (79 eyes) with periocular and subconjunctival dirofilariasis in a tertiary eye institute in South India over the past 11 years (2013-2024). The inclusion criteria include only those cases that are confirmed by histopathology or microbiology examination. Patients with histopathology examination suggestive of only parasitic etiology without definitive features of Dirofilaria were excluded from the study.

[OBSERVATION PROCEDURE] The case records were reviewed to document the clinico-demographic profile, imaging, microbiological and/or histopathological features, and management outcomes.

[THE MAIN OUTCOME MEASURES] The primary outcome measure was complete resolution of symptoms and signs.

[RESULTS] The mean age at presentation was 47.73+/-19.4 years. There were 29 males and 50 females. The mean duration of symptoms was 1.36+/- 2.14 months. The most common presentation was a lid mass (70.9%). The most common location of the worm was in the lower lid (43.1%), followed by the upper lid (31.6%), subconjunctival space (21.5%), orbit (2.5%), and suprabrow (1.3%). Ultrasound sonography (USG) was done in 19% cases, of which 17.7% showed characteristic features suggestive of Dirofilaria. Direct worm removal was done in nine (11.4%) patients, and excisional biopsy in 69 (87.3%). In one (1.3%) patient, the worm was found accidentally during a lower lid blepharoplasty.

[CONCLUSION] We conclude that dirofilariasis should be considered an important differential diagnosis in subcutaneous migratory swellings, conjunctival nodules, and periocular inflammatory and mass lesions. An ultrasound scan should be considered as the imaging of choice in suspected periocular dirofilariasis.