Masquerade: Cattle tick bite over medial canthi

Tick infestation of ocular tissues can present as masquerades and is quite uncommon. But it cannot be neglected in our part of the country as the majority of the population have domestic animals in their household. Tick bites can occur irrespective of age or gender and are usually presented late to the clinic and misdiagnosed often due to their appearance and site of infestation. In this case report, we present a case of a 57-year-old female who came to our outpatient clinic with complaints of severe pain and mild swelling of her left upper lid since 5 days. Under local anaesthesia, we found a tick biting the medial canthi region, the tick was removed using a plain non-toothed forceps and was identified as a tick of Ixodes species. The patient was advised oral doxycycline 200 mg single dose and topical moxifloxacin 0.5% 6 times a day to the left eye. She was followed up in subsequent weeks and she was doing well with no other complications.