Successful Treatment of Corneal Larva Migrans by Nd:YAG Laser Photodisruption

An eight‐year‐old girl presented with a one‐week history of redness in the right eye. Best corrected visual acuity was 6/6 bilaterally. The right eye showed mild circumcorneal congestion and a worm in the central cornea [Figure 1], which showed a wiggling motility under high magnification of slit lamp. The rest of the ocular examination was normal. Considering the very central location of the worm in cornea, any intervention to remove or destroy the worm was deferred on that day. By the next day, the worm had migrated to the peripheral cornea at the 10 o’clock position [Figure 2]. We decided on Nd: YAG laser photodisruption of the worm, rather than its surgical removal. Laser parameters of 1 mJ and single pulse delivery were selected. The focal point of the aiming beam was set directly at the focal point of the laser disruption. After careful counseling and topical anesthesia with 0.5% proparacaine eye drops, an Ocular Abraham Iridectomy lens (Product Code: OAIY, Ocular instruments, Bellevue, Washington, USA) was applied to the ocular surface with coupling fluid. The laser was applied to both ends of the worm because it was not possible to distinguish between the head and tail ends. Two bursts of laser were directed at Successful Treatment of Corneal Larva Migrans by Nd:YAG Laser Photodisruption