Lice and nits, preauricular lymphadenopathy, and follicular conjunctivitis are all associated with which ocular finding?

• A. Phthiriasis palpebrarum
• B. Angular conjunctivitis
• C. Inclusion conjunctivitis
• D. Vernal keratoconjunctivitis

Answer: (A)

Lice and nits on the eyelashes point to phthiriasis palpebrarum, an eyelid infestation by Phthirus pubis. This condition commonly causes itching and irritation, and you can often see the lice or their eggs (nits) clinging to the lash base. The inflammation they provoke can lead to follicular conjunctivitis and may be accompanied by preauricular lymphadenopathy due to the localized irritation.

Angular conjunctivitis from Moraxella lacunata tends to show redness and discharge at the lateral or medial angles of the eye rather than visible eyelash parasites. Inclusion conjunctivitis (often from Chlamydia) can have follicles and preauricular nodes but lacks lice or nits on the lashes. Vernal keratoconjunctivitis is an allergic condition with characteristic giant papillae and limbal involvement, not infestation. Thus, the presence of lice and nits with follicular conjunctivitis and preauricular nodes best indicates phthiriasis palpebrarum.