Infection caused by the filarial parasite of the genus Dirofilaria, clinically known as Dirofilariasis, is a zoonotic helminthic infection that is largely endemic in Mediterranean countries and commonly affects animals, mostly dogs, raccoons, wolves and foxes. Human infection is uncommon. Mosquitoes are the vectors in the disease cycle and humans are the final host of this parasite. Ocular dirofilariasis, although uncommon, has been reported from various parts of the world with reports of periorbital, subconjunctival, orbital and intraocular involvement. Previously published reports of conjunctival dirofilariasis have described patients presenting with ocular discomfort, intense pain, and redness. In our case, conjunctival dirofilariasis was found to manifest as a painless, cystic, nodular mass [Fig. 1a]. Surgical removal of the lesion with histopathological confirmation is the preferred treatment with anti-helminthic therapy having no role in the management [Fig. 1b and c]. Dirofilariasis should be considered a differential diagnosis when evaluating a patient who presents with a painless cystic conjunctival mass, even in a traditionally non-endemic area.
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