Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1998 Jan;82(1):59–62. doi: 10.1136/bjo.82.1.59

Ocular changes associated with Giardia lamblia infection in children

A Corsi 1, C Nucci 1, D Knafelz 1, D Bulgarini 1, I Di 1, A Polito 1, F De Risi 1, F Morini 1, F Paone 1
PMCID: PMC1722351  PMID: 9536883

Abstract

BACKGROUND—The protozoan disease giardiasis can cause ocular complications, including "salt and pepper" retinal changes.
METHODS—Ophthalmic examinations were performed in 141 children (mean age 4.7 (SD 2.0) years) with active or past giardiasis diagnosed on the basis of microscopic examination of stool specimens or duodenal secretions—53 were newly diagnosed and untreated (group A), 50 had active infections in spite of metronidazole therapy (group B), and 38 had been successfully treated, with negative stool specimens for 1-3 years (group C). 300 children with no evidence of giardiasis were used as controls.
RESULTS—Salt and pepper retinal changes (with normal electroretinographic findings) were diagnosed in 28 (19.9%) of the patients with giardiasis (11 from group A, 10 from group B, and seven from group C), including five pairs of siblings. In all subgroups, the children with retinal changes were consistently younger than those with normal retinas. In eight cases, the lesions could be visualised only with direct ophthalmoscopy.
CONCLUSION—Our findings indicate that asymptomatic, non-progressive retinal lesions are particularly common in younger children with giardiasis. This risk does not seem to be related to the severity of the infection, its duration, or the use of metronidazole but may reflect a genetic predisposition.

 Keywords: gastrointestinal disease; Giardia lamblia; eye; retina

Full Text

The Full Text of this article is available as a PDF (112.5 KB).

Figure 1  .

Figure 1  

(A) and (B) Photographs showing typical "salt and pepper" appearance of the retina.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beal C. B., Viens P., Grant R. G., Hughes J. M. A new technique for sampling duodenal contents: demonstration of upper small-bowel pathogens. Am J Trop Med Hyg. 1970 Mar;19(2):349–352. doi: 10.4269/ajtmh.1970.19.349. [DOI] [PubMed] [Google Scholar]
  2. CARROLL M. E., ANAST B. P., BIRCH C. L. Giardiasis and uveitis. Arch Ophthalmol. 1961 Jun;65:775–778. doi: 10.1001/archopht.1961.01840020777002. [DOI] [PubMed] [Google Scholar]
  3. DJABRI S. E., DIALLINAS N. L'IMPORTANCE DE LA LAMBLIASE COMME FACTEUR 'ETIOLOGIQUE DANS LA CHORIOR'ETINITE CENTRALE S'EREUSE. Ophthalmologica. 1964;147:264–272. doi: 10.1159/000304600. [DOI] [PubMed] [Google Scholar]
  4. Erlandsen S. L., Chase D. G. Morphological alterations in the microvillous border of villous epithelial cells produced by intestinal microorganisms. Am J Clin Nutr. 1974 Nov;27(11):1277–1286. doi: 10.1093/ajcn/27.11.1277. [DOI] [PubMed] [Google Scholar]
  5. Holberton D. V. Fine structure of the ventral disk apparatus and the mechanism of attachment in the flagellate Giardia muris. J Cell Sci. 1973 Jul;13(1):11–41. doi: 10.1242/jcs.13.1.11. [DOI] [PubMed] [Google Scholar]
  6. Janoff E. N., Taylor D. N., Echeverria P., Glode M. P., Blaser M. J. Serum antibodies to Giardia lamblia by age in populations in Colorado and Thailand. West J Med. 1990 Mar;152(3):253–256. [PMC free article] [PubMed] [Google Scholar]
  7. Knox D. L., King J., Jr Retinal arteritis, iridocyclitis, and giardiasis. Ophthalmology. 1982 Dec;89(12):1303–1308. doi: 10.1016/s0161-6420(82)34636-9. [DOI] [PubMed] [Google Scholar]
  8. Pettoello Mantovani M., Giardino I., Magli A., di Martino L., Guandalini S. Intestinal giardiasis associated with ophthalmologic changes. J Pediatr Gastroenterol Nutr. 1990 Aug;11(2):196–200. doi: 10.1097/00005176-199008000-00007. [DOI] [PubMed] [Google Scholar]
  9. Pickering L. K., Engelkirk P. G. Giardia lamblia. Pediatr Clin North Am. 1988 Jun;35(3):565–577. doi: 10.1016/s0031-3955(16)36472-0. [DOI] [PubMed] [Google Scholar]
  10. Roberts-Thomson I. C., Mitchell G. F., Anders R. F., Tait B. D., Kerlin P., Kerr-Grant A., Cavanagh P. Genetic studies in human and murine giardiasis. Gut. 1980 May;21(5):397–401. doi: 10.1136/gut.21.5.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. WEBSTER B. H. Human infection with Giardia lamblia; an analysis of 32 cases. Am J Dig Dis. 1958 Jan;3(1):64–71. doi: 10.1007/BF02231310. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES