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Onchocerciasis (river blindness)

Onchocerciasis is a tissue parasitic infestation caused by a filarial worm, Onchocerca volvulus.

The microfilariae invade lymphatic system, subcutaneous and deep tissues producing acute inflammation and chronic inflammation at a later stage.  

Diagnostic Criteria

  • They are caused by the chronic inflammation which presents with:

  • Skin inflammation with papules

  • Subcutaneous nodules

  • Atypical skin lesions (scarred, saggy, hanging areas of skin, leopard skin)

  • Skin nodules under the bony prominent areas

  • Microfilaria in anterior chamber

  • Scleritis and Keratitis leading to Impaired vision as well as blindness.


  • Rapid diagnostic test (OV-16 - Onchocerciasis IgG) 

  • Skin snip for microscopic examination

  • Slit lamp eye examination. 


Pharmacological Treatment

Treatment is done in consultation with dermatologists and infectious disease specialists. Apart from WHO recommended mass treatment campaign to community at risk with annual preventive chemotherapy which polarize/paralyze the worm, treatment depends on individual patient presentation. 

Ivermectin 0.15 mg/kg (PO) once every 12 months for 12–15 years 


  • Patients with heavy ocular infestation require retreatment every 3 to 6 months. 

  • Treatment will only arrest progression of the clinical features but not revese them


Dosage guidelines based on body weight


Surgical treatment

Nodulectomy: It is done mostly for nodules located in the scalp to minimize the ocular complications.          

Updated on, 2.11.2020


1. STG 

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