A case report of ophthalmorrhagia caused by leech attachment

A leech attachment in the eye is very rare, yet leeches usually attach themselves to the throat, nasal mucus, esophagus, pharynx, rectum, and vagina. A leech can cause epistaxis, haematemesis, hemoptysis rectal and vaginal hemorrhage. In this article, a case of the eye contact to leech is reported. A seven year old boy with eye hemorrhage, who suffered from an attached leech in the limbus of the left eye and had a history of swimming in his village stream, was assessed. The patient was first diagnosed as a corneal perforation and prolapse of the iris. However, slit lamp examination showed a brown-gray waveringly moving mass resembling a leech, which had apparently penetrated into the mucus and was sucking the blood and causing hemorrhage. Besides, conjuctival bleeding was seen around this spot. The leech was taken out in the operation room under topical anesthesia using tetracain 5%. Finally, bleeding was stopped under pressure dressing. The following day, examination of the case revealed the biting spot of the leech in temporal limbus and conjuctival bleeding.. The patient received an antibiotic drop (Chloramphenicol 0.5%) and a steroid drop (Betametasone 0.1%), which resulted in the elimination of all symptoms after one week. Although parasitic living of leech in the eye is rare if present, it can cause profuse hemorrhage on the surface of the eye. Thus it is important to suspect that a leech has already infested a patient who has no history of trauma but suffers from ophthalmorrhagia, has a history of swimming in rivers and/or washing the face in rivers or puddles of water,and is a rural inhabitant. Therefore, having a leech in the eye-as a differential diagnosis-must be taken into account.