Ocular leech infestation – A case report and literature review

We report a rare case of ocular infestation by a leech in a six-year-old male and provide an overview of the literature on similar cases. The patient presented with ocular pain, foreign body sensation, and redness after swimming in a natural spring. A leech was discovered above the cornea and removed using forceps under topical anesthesia, followed by a short course of topical antibiotics and corticosteroids. Symptoms resolved within days, except for subconjunctival hemorrhage, which took 2–3 weeks. The leech was characterized by an entomologist as Limnatis nilotica. A literature review of 12 comparable cases revealed that the Middle East had the highest number of reported cases, primarily linked to contact with spring water. Common symptoms included ocular pain, foreign body sensation, and redness. The primary treatment involved forceps removal of the leech and topical medications, with no reported complications. This report contributes to the limited documentation on ocular leech infestation and presents the first comprehensive review of such cases.