SUMMARY We present a case of intraocular pentastomiasis in a 12-year-old Israel Arab boy. A single secondary pentastomid larva, most likely of Linguatula serrata, was found in the anterior chamber of the right eye, attached loosely to the pupil's border by a fibrinous mass. Associated conditions were iritis, subluxation of the lens, and secondary glaucoma. This is the first documentation of human pentastomiasis in Israel.Cases of human pentastomiasis involving the eye are relatively rare. In so far as we have been able to trace them, there are only 10 previous reports of ocular pentastomiasis: four of these are from the USA and were due to larval Linguatula serrata'"4; the remaining six are from Africa and were caused by Armillifer armillatus.5"The present case is of an Israeli Arab boy who suffered from unilateral glaucoma secondary to iritis which was provoked by a larval Lingutulid. This is the first report of human pentastomiasis from Israel. Case reportA 12-year-old Israeli Arab boy from a neighbouring village was referred to our clinic because of high intraocular pressure in his right eye. The boy said he had suffered pain in his right eye for about a week, beginning after 'something believed to be a fly hit it'. On admission he had a visual acuity of 30 cm finger counting on the affected right eye. The intraocular pressure was 48 mmHg by applanation. The cornea was oedematous, with some flare in the anterior chamber. The pupil was 3 mm wide, round and free, the lens clear but with partial iridodonesis on the lower nasal quadrant. On ophthalmoscopy there was a glaucomatous cupping of 0-8 cup/disc ratio in the optic disc. Gonioscopy revealed several anterior goniosynechiae, particularly at 9 and 11 o'clock. The visual acuity of the left eye was 6/6, the intraocular Secondary glaucoma of the right eye was diagnosed and the boy was given tablets of acetazolamide 0-125 g four times a day, topical drops of homatropine 1% with topical steroids three times a day and timolol maleate 0-25% twice daily. The following day, on mydriasis, a subluxation of the lens was observed. The intraocular pressure diminished to 28 mmHg but increased again to 35-40 mmHg on subsequent days. Nine days after admission, and on failure of the conservative treatment, an uneventful trabeculectomy was performed.On the first postoperative day, in the course of slitlamp examination, we noticed a white segmented mass in the anterior chamber which was encased in a fibrinous sheath and attached loosely to the pupil's border at 12 o'clock ( Fig. 1). This fibrin coated and slightly crescent shaped mass changed its position several times during the next few days. Laboratory tests, including a complete haematological examination, gave normal results. Stool examinations for parasites were negative. Meanwhile there was no alleviation of the intraocular pressure.One week after the trabeculectomy the mass was removed from the anterior chamber via limbal paracentesis. We were obliged to cut the fibrinous sheath in order to liberate the segmented mass an...

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