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River blindness* (Onchocerciasis)


  1. Caused by infection of onchocerca volvulus, a nematode.
  2. Endemic in Africa , central and south America.
  3. Vector is Blackfly*
  4. Ocular features – Route of entry into eye is not clear
    1. Anterior uveitis - Earliest sign- small, white wriggling worm in the anterior chamber may be seen
    2. Sclerosing Keratitis – Major cause of blindness
    3. Chorioretinitis → Chronic, non granulomatous
    4. Macula – Tends to be spared
    5. Visual filed defects and night blindness is out of proportion to the fundus changes.
    6. Finally leads to extensive retinal atrophy and scarring
Tt- Ivermectin*:  Given only to those at high risk for blindness because treatment can lead to severe , acute, systemic , inflammation { called MAZZOTI’S REACTION*} that can cause death

* Control of onchocerciasis is included in vision 2020 Program me

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