![]() In these cases both patients reached immediate hospital treatment. 5, 6 A 4-year-old girl in south-west Germany 5 with Theromyzon tessulatum (duck leech) infestation and a 7-year-old boy in Turkey 6 with Limnatis nilotica infestation. In a hospital emergency setting, there have only been two reported cases of ocular leech infestation, to the authors’ knowledge. The land leech commonly encountered by bushwalkers is included in this group. The blood is prevented from clotting by production of a nonenzymatic secretion called hirudin. One group (the jawed leeches or Gnatbobdellida) have jaws armed with teeth with which they bite the host. Different types of leeches are grouped according to the different ways they feed. 2 In a hospital setting, leeches have been used to drain periorbital and scrotal haematomas, 1, 3 but in these cases the leeches detach from the skin once they have finished their meal. 1 They play a useful role in modern plastic surgery because of their superb decongestant properties. ‘Leechmania’ or the use of medicinal leeches has occurred for over 2500 years. ![]() There was no evidence of scleral perforation and he made a complete recovery. ![]() He sustained a large subconjunctival haemorrhage ( Figure 1b), which resolved completely in 14 days. The patient's visual acuity remained 6/6 throughout. A patch was placed over the eye and the patient was evacuated on foot for further assessment. The eye was then irrigated with 2 litres of normal saline and chloramphenicol ointment applied to the eye. This was removed with direct application of cooking salt to the leech and gentle traction with forceps ensuring the head was not left in the wound. The mass was identified as a tiger leech ‘ Haemadipsa picta’ ( Figure 1a). On ophthalmological examination he had intense blepharospasm and a tissue mass attached to the temporal bulbar conjunctiva of his right eye, with surrounding subconjunctival haemorrhage. ![]() During a trekking expedition to the Borneo jungle, a 28-year-old man presented with a 5 min history of ocular pain after a foreign body hit his right eye while attaching a hammock to a tree. ![]()
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