Tick Infestation of the Eyelid: Two Case Reports

Abstract

Background: Tick infestation of the eyelid is an uncommon ophthalmic condition that may mimic benign eyelid lesions and delay diagnosis. Prompt recognition and complete removal are essential to prevent local complications and the transmission of tick-borne diseases.

Case Presentation: We report two female patients, aged 55 and 70 years, who presented with painful, erythematous swelling of the upper eyelid associated with a brownish wart-like lesion. Slit-lamp examination revealed attached ticks, identified clinically as a soft tick in the first case and a hard tick in the second. Both ticks were carefully removed intact using blunt toothless forceps without rupture. The specimens were sent for microbiological evaluation, and laboratory investigations were performed to assess possible systemic involvement. Both patients received prophylactic antibiotic therapy and were advised regarding symptoms of tick-borne illnesses. No systemic manifestations were observed at presentation.

Conclusion: Eyelid tick infestation is a rare but clinically significant condition that requires a high index of suspicion. Careful slit-lamp examination, complete tick removal, and appropriate follow-up are crucial to minimize ocular and systemic complications. Awareness of this uncommon presentation can facilitate early diagnosis and successful management.