APR 02, 2020
Video of the Surgical Management of a Live Intravitreal Nematode
AAO 2019 Video Program
Retina/Vitreous
A 35-year-old man presented with a six-week history of left eye pain, blurriness, photophobia and floaters. He had no significant past medical history. His visual acuity was 20/40, and dilated fundus examination revealed moderate vitritis with a live nematode suspended within the vitreous humor. The patient consented to surgical removal. A limited core vitrectomy was performed to free the nematode from the vitreous. Although it was initially suspected that the nematode was dead, its head seemed to curl during surgery. A 20-gauge angiocath was shortened and beveled at the tip and then was inserted into the vitreous cavity. The angiocath was connected to the viscous fluid extractor and the nematode was aspirated. The remaining vitreous attachments to the worm were cut and the angiocath was removed. The nematode was seen in the syringe. The nematode morphology was most consistent with Toxocara species.