Obed Uba was just 12 when the itching began. He recalls the mild redness after football matches. He vision seemed to blur when he tried to read.
He dismissed the irritation as a strain, washing his eyes with water, and sometimes wetting them with vials of eye drops that his parents bought from the local chemist.
“I thought it was normal,” he recalls. But the itch only worsened as the years wore on. By age 15, dark circles had formed around his eyes. He had begun squinting at the chalkboard.
Uba’s experience is not uncommon in Nigeria. Many young people typically ascribe their itchy or red eyes to dust, smoke, or long exposure to their white light from their smartphones. As is often the case, though, a small irritation degenerates into a severe problem.
A worm’s itinarary
Oguchi Blessed, an optometrist based in Cross River, explains that eye irritations can be linked to worms in the gut.
“Worms in the stomach can affect the eye when larvae, especially from the gut, travel down the bloodstream and then make their way to the eye.”
More often than not, intestinal worms are regarded as a problem afflicting only children and treated with a tablet. But these worms are hardly stationary, causing devastating scars to delicate tissues.
If they invade the retina, the part responsible for sharp vision, the result is permanent central vision loss. In the cornea, painful ulcers can develop, leaving scars that block vision. These outcomes are devastating, particularly because they are preventable.
Nearly a quarter of the world’s population, 1.5 billion people, carry soil-transmitted worms like roundworm, hookworm, and whipworm. Nigeria–with its warm climate, poor sanitation, and gaps in public health coverage–remains one of the most affected countries.
For people like Uba, the damage builds slowly over years.
Blessed reels off a litany of eye problems that deserve serious concern, including African eye worm (Loiasis), river blindness (onchocerciasis) and toxoplasmosis, a parasitic illness contracted by eating undercooked meat.
Nigeria carries the highest burden of Onchocerciasis worldwide, with more than 20.9 million people at risk and over 40% of all global cases. Spread by blackflies, it scars the cornea, damages the retina, and affects communities living near rivers.
A survey in Nigeria shows that about 78% of pregnant women in Nigeria tested positive for toxoplasmosis antibodies. Experts link this high incidence to poor awareness of the disease and the absence of effective control measures.
Toxoplasmosis leaves scars on the retina, covering the macula, which is responsible for sharp vision.
Meanwhile, patients infected with Loiasis frequently report a shock when the worm crawls across their eyes.
Why children are more at risk
Like Uba, teenagers and kids face higher risks than adults, not only because their immune systems are still developing but also because of their habits.
“That’s why we advise parents, especially those that keep pets like dogs and cats to be extremely careful with their kids,” Blessed cautions. “Keep the environment clean and always vaccinate those pets. Whenever cats or dogs defecate, they should not allow the toddlers close to them.”
Research has shown that many individuals that have pets, especially dogs and cats are prone to toxocariasis and toxoplasmosis.
Globally, more than 600 million children live in areas where intestinal worms are common. In Nigeria, there are deworming tablets made available for schoolchildren, but coverage often falls short of the WHO target.
The cost of delayed treatment
What happens when worm-related eye infections are left untreated?
“It can lead to blindness… especially in the cases of toxoplasmosis. It forms a scar on the macular or close to the macular causing blindness,” Blessed warns.
In Nigeria, where 1.3 million people are blind and another 24 million live with moderate-to-severe vision loss, worms play a hidden but significant role in the national burden of blindness.
Although cataracts and refractive errors dominate statistics, infectious and parasitic causes persist, particularly in rural and riverine areas.
Uba’s story illustrates how neglect allows infections to fester.
The danger of self-medication
More than 79% of respondents in one study reported using eye drops for self-medication. These drops, often containing steroids, reduce symptoms but weaken the body’s ability to fight infections.
Severe itching, Blessed adds, can “cause cornea abrasion,” a scratch or injury on the clear, protective surface at the front of the eye. She recommends proper hygiene as a formidable defense.
The CDC reports that the majority of toxoplasmosis infections are linked to food. UNICEF notes that improved sanitation alone can reduce worm transmission. Simple hygiene habits could save thousands from vision loss every year.
Her words echo the hidden dangers of worm-related eye problems. Many patients never realise their vision loss is linked to their diet, habits, or environment.
Uba’s experience demonstrate how intestinal worms pose devastating hazards that affect the overall health.
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