Episcleral nodules and hygiene

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Over the past 4-5 years, I have noticed children coming to the hospital with inflamed episcleral nodules, which did not respond to topical antibiotics or steroids and anti helminthics. Blood reports were insignificant and stool examination done for three cases were inconclusive. Once regularity was noted, exised lesions were sent to Christian Medical College (CMC) Vellore. Biopsy was done on 12 cases. Of these, 8 reported that the lesions were probably of parasitic origin.

The interesting part of the exercise was that, of the 8 reports of lesions of parasitic origin, 7 were of Sri Lankan refugees, from a Sri Lankan refugee colony situated on the banks of the Bhavani river, in Mettupalayam. The river is the main source of drinking water for the people of the colony. After repeated visits to the colony to study the problem, health education talks were given on the use of boiled water for consumption, spread of diseases through impure water, and the importance of personal hygiene.

Oral helminthic, Albendazole, was given to every child, with another dose after a gap of 2 weeks.

In our follow-up visits, we have not seen any case of episcleral nodules from this village for the past four years. This was part of a large programme called ‘Operation Community Care’.