Rare Thelazia californiensis infant ocular infestation

PURPOSE: A rare case of Thelazia californiensis ocular infestation was diagnosed and treated in an 11-month-old patient. OBSERVATIONS: The patient presented with a visual acuity of 20/130 OU by Teller cards. Exam demonstrated a white, mobile worm in the inferomedial fornix of the right eye. The remainder of the exam was otherwise normal. The worm was removed under anesthesia and identified as Thelazia californiensis by the Division of Parasitic Diseases and Malaria, at the Centers for Disease Control and Prevention. CONCLUSIONS AND IMPORTANCE: This case demonstrates a rare but important cause of follicular conjunctivitis and mobile foreign bodies, especially in patients with a supportive history of exposure to the intermediate and definitive hosts of Thelazia species.