PMC4427139_01
a Live larval paralysis tick attached to the patient's right temporal bulbar conjunctiva. b Surgical removal of the larval tick and surrounding conjunctiva using Bonn 0.12-mm forceps and straight Vannas scissors. The position of the tick on the conjunctiva is indicated by the black arrow.
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F1
Slit lamp examination revealed a live translucent-bodied organism with pulsatile fluid movement (at a different rate to the patient's heart), firmly attached to his right temporal bulbar conjunctiva (fig. 1a). Under general anaesthesia, the conjunctival tissue and the organism onto which it was attached (see arrow in fig. 1b) were elevated and excised en bloc.
Biopsy of tissue excised from the right temporal conjunctiva showing mouthparts of the tick within stroma.
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F2
Histopathological examination revealed deep embedding of the larval tick's mouthparts, with extension into the conjunctival stroma (fig. 2).