OCULAR CYSTICERCOSIS AS A CAUSE OF CHRONIC RETINAL DETACHMENT AND III CRANIAL NERVE PALSY IN A PEDIATRIC PATIENT: CASE REPORT
Keywords:
ocular cysticercosis, retinal detachment, third cranial nerve palsy, vitritis, Taenia solium, pediatricsAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0886
Abstract
Ocular cysticercosis is a rare manifestation of Taenia solium infection that may present with severe visual impairment, particularly dangerous in childhood due to the potential for irreversible sequelae. Timely diagnosis requires a high index of clinical suspicion and a multidisciplinary approach. We report the case of a 4-year-6-month-old male patient from Guayaquil, Ecuador, presenting with a 3-month history of right divergent strabismus, pulsating holocranial headache with nocturnal awakenings, dizziness, and progressive right visual field loss. External serology was positive for Cisticercus/T. solium IgG antibodies (titer 2.24). B-mode ocular ultrasound revealed vitritis and funnel-shaped retinal detachment; Doppler ultrasound confirmed chronic retinal detachment with vitreous and subretinal hemorrhage in the right eye. Contrast-enhanced orbital MRI showed hematic debris in the vitreous humor. Neuroimaging (CT scan and angio-MRI) excluded intracranial compressive lesions. Treatment was initiated with albendazole 15 mg/kg/day for 14 days combined with corticotherapy (prednisone 1 mg/kg/day). Surgical resolution (vitrectomy + laser + peeling) was scheduled electively on an outpatient basis. Ocular cysticercosis should be considered in the differential diagnosis of children presenting with progressive unilateral visual loss, acquired strabismus, and headache in endemic regions. Multimodal diagnosis —serology, ocular ultrasound, and MRI— is essential to guide management and avoid unnecessary surgical procedures during the active inflammatory phase.
Keywords: ocular cysticercosis, retinal detachment, third cranial nerve palsy, vitritis, Taenia solium, pediatrics.
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