Nd:YAG photodestruction of a presumed corneal Toxocara canis larva.
OBJECTIVE
To describe the technique of Nd:YAG photodestruction of a presumed Toxocara canis corneal larval migrans and to report the unique clinical combination of a corneal nematode and diffuse unilateral subacute neuroretinitis (DUSN).


METHODS
Clinical case report.


RESULTS
A 63-year-old white male presented with idiopathic neuroretinitis treated empirically with systemic anti inflammatory therapy. Subsequently, he developed keratouveitis with an obvious corneal larva. Serology was positive for T. canis. Laser destruction of the larva combined with topical steroid and oral albendazole therapy led to initial resolution, followed by 1 episode of recurrent keratouveitis without identified ocular surface or intraocular larvae. This was cleared with topical steroids. A second empiric course of oral albendazole was also administered. The patient has shown no ocular recurrences or evidence of systemic involvement 1 year after the second course of treatment.


CONCLUSIONS
Corneal larvae can be safely and successfully destroyed by Nd:YAG photodestruction. T. canis may be one of several nematodes responsible for DUSN. A careful examination of the anterior segment is essential in the management of patients with DUSN.
Novak
Kenneth D
KD
Eye Associates of Utica, PC, Utica, NY, USA. eyeassociatesofutica@roadrunner.com
Williams
Steven M
SM
Kokot
Irena
I
Schultze
Robert L
RL
D000818:Animals; D003316:Corneal Diseases / Q000469:parasitology / Q000601:surgery*; D015822:Eye Infections, Parasitic / Q000469:parasitology / Q000601:surgery*; D005451:Fluorescein Angiography; D006801:Humans; D007815:Larva Migrans / Q000473:pathology / Q000601:surgery*; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017166:Toxocara canis / Q000302:isolation & purification*; D014792:Visual Acuity