Abstract

A 26-year-old postpartum mother presented with diminution of vision in left eye for 2 weeks. Her best-corrected visual acuity was 6/36 in the left eye (LE). Ophthalmoscopy of LE showed retinal pigment epithelium tracks and presence of a live nematode in the supero-temporal quadrant, 2DD in size with adjacent fresh laser marks. Optical coherence tomography line scan located it beneath the Internal limiting membrane (ILM). Green laser photocoagulation was repeated. Oral Albendazole 400mg OD and Prednisolone 40 mg OD given. To our dismay the worm was motile on follow up visit, though the mobility had reduced and it had not migrated. Laser was repeated, considering the demographic habitat, we presume filarial organisms as a cause. Oral Diethylcarbamazine 100 mg BD was given. The worm disintegrated, vision improved to 6/24. The sub-ILM location of the worm is extremely rare. Repeat examination is a must to ensure that the worm is immobile, worms can be resistant to photocoagulation.