Dangerous waters: Outbreak of eye lesions caused by fresh water sponge spicules

A. A.V. Cruz, V. M. Alencar, N. H. Medina, C. Volkmer-Ribeiro, V. L. Gattás, E. Luna

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


PurposeTo describe an extremely uncommon outbreak of eye lesions in a specific area of the Brazilian Amazonia.MethodsProspective noncomparative case series. Fifty-nine patients who developed eye lesions after swimming in the Araguaia river of Tocantins state in Brazil were examined. A team of ophthalmologists equipped with a slit-lamp, gonioscopic lenses, and indirect ophthalmoscopy performed full eye examination. Analysis of the flora and fauna of the river water was undertaken by a group of experts.Results and ConclusionsEighty-three eyes were affected. The most common lesions were corneal opacities seen in 34 eyes and conjunctival nodules diagnosed in 12 eyes. Severe visual acuity loss was detected in seven children with unilateral anterior chamber lesions. Spicules of the sponge species Drulia uruguayensis and Drulia ctenosclera were found inside three blind eyes that have been enucleated for diagnostic purposes. All eye lesions could be attributed to an outbreak of foreign bodies from fresh water sponges. Organic enrichment of the water resulting from the absence of sanitation probably was the key factor, which initiated a cycle of ecological imbalance that provoked human disease.

Original languageEnglish (US)
Pages (from-to)398-402
Number of pages5
JournalEye (Basingstoke)
Issue number3
StatePublished - Mar 2013
Externally publishedYes


  • Amazonia
  • conjunctival nodules
  • eye lesions
  • foreign body
  • fresh water sponges

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems


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