Loa loa macrofilariasis in the eyelid: case report of the first periocular subcutaneous manifestation in India

We report a case of periocular subcutaneous macrofilariasis as an initial sign of a systemic Loa loa infection. Thorough history, eye examination, surgical intervention and parasitological analysis. A periocular adult Loa loa worm was extracted from the left upper eyelid of an Indian lady living in Mumbai after presenting to our department with sensation of worm crawling under the left upper eyelid skin. Patient was admitted and was treated with diethylcarbamazine, oral steroids and albendazole with steroid cover under observation. In an era of increasing global travel, this case highlights the importance of direct questioning of previous travel as signs may be nonspecific and transitory. With clinical suspicion of Loa loa infestation, initiation of systemic investigation should not be prolonged and early treatment should be started under observation.