|Year : 2016 | Volume
| Issue : 3 | Page : 405-406
Phthirus pubis in the eye
A Singh1, K Tripathy1, N Gupta2, P Kale2, N Verma2, BR Mirdha2
1 Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
2 Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
|Date of Submission||27-Sep-2015|
|Date of Acceptance||14-Dec-2015|
|Date of Web Publication||12-Aug-2016|
B R Mirdha
Department of Microbiology, All India Institute of Medical Sciences, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh A, Tripathy K, Gupta N, Kale P, Verma N, Mirdha B R. Phthirus pubis in the eye. Indian J Med Microbiol 2016;34:405-6
Phthirus pubis infestation is a clear indicator of poor hygiene and overcrowding with a worldwide prevalence of 1-2%.  The adult louse is semitransparent and has a distinctive crab-like body. The dark coloured nits laid by the female lice usually adhere to the hairs.  The infestation is common in sexually active age group and may be associated with other sexually transmitted infections (STIs) in over 30% of the cases. 
A 41-year-old female presented with pain and irritation in both eyes for last three months. Detailing of physical examination and clinical history was not remarkable. She had no history of any other STI and no known infestation elsewhere in her body. Slit lamp biomicroscopy revealed multiple eggs adhered to eye lashes along with three moving insects at the lid margin. The examination of insects under light microscopy revealed wingless, translucent crab-like lice with three pairs of legs along with claws. The size was 1.6 mm, and the insect was confirmed as P. pubis [Figure 1]. The patient was successfully treated with mechanical removal of insects and nits along with instillation of 1% permethrin topically. Close contacts were also advised treatment. Her husband was also advised for thorough check up for pubic louse infestation.
|Figure 1: Light microscope, ×100 magnification, shows adult Phthirus pubis adhered to an eye lash removed from the patient|
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Phthiriasis palpebrarum (infestation of eye) is uncommonly reported from India.  They are commonly misdiagnosed as blepharoconjunctivitis of bacterial or viral aetiology. The possibility of pubic infestation in cases not responding to antimicrobials should be kept in mind. It is also important to trace the contacts and treat them adequately. Treatment options include mechanical removal, 1% permethrin lotion, lindane lotion and oral therapy with ivermectin. 
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Conflicts of interest
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