River blindness, often known as onchocerciasis, is a neglected tropical disease (NTD) characterized by the parasitic worm Onchocerca volvulus. Repeated attacks by blackflies of the genus Simulium spread it. River blindness is named for the blackfly that spreads the virus, which lives and spawns along fast-flowing streams and rivers, usually near distant rural towns. The infection may cause vision impairment and, in severe cases, blindness.

Moreover, river blindness may also induce skin problems, such as acute itching, nodules, or rashes beneath the skin. It is the world’s second most prevalent infection cause of blindness, after trachoma.


River blindness progresses through many phases. During the initial phases, you might not experience any symptoms at all. It might take up to a year for symptoms and the infection to become visible.

When the infection gets severe, the following symptoms may appear:

  • Extreme itching
  • Skin elasticity loss, which may cause the skin to seem thin and brittle
  • Skin pigmentation changes
  • Cataracts
  • Vision loss
  • Skin rashes
  • Bumps under the skin
  • Eyes itching
  • Enlarged groin
  • Light sensitivity

Swollen lymph glands are also possible in rare cases.


River blindness is diagnosed using a variety of tests. Typically, the initial step is for a doctor to feel the skin for nodules.

A skin biopsy, sometimes known as a skin snip, will be performed by your general practitioner. A 2 to 5-milligram portion of the skin will be extracted during this procedure. After that, the biopsy is placed in a saline solution, which causes the larvae to release. Several snips, generally six, are extracted from various body areas.

Other tests may include:

  • Mazzotti test
  • Nodulectomy
  • Enzyme-linked immunosorbent assay (ELISA)
  • Rapid-format antibody card test
  • Polymerase chain reaction (PCR) test


Ivermectin (Stromectol) is the most often used medication for river blindness. Most individuals find it safe, and it only has to be consumed once or twice a year to be successful. It also does not need to be put on the refrigerator. It functions by inhibiting female blackflies from producing microfilariae.

Controlled experiments were done to determine whether or not combining ivermectin with doxycycline (Vibra-Tabs, Doryx, Acticlate) would be more successful in treating onchocerciasis. The outcomes could have been clearer, partly because of difficulties with how the experiments were carried out.

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