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Onchocerciasis is an eye and skin disease. Symptoms are caused by the microfilariae, which move around the human body in the subcutaneous tissue and induce intense inflammatory responses when they die. Infected people may show symptoms such as severe itching and various skin changes. Some infected people develop eye lesions which can lead to visual impairment and permanent blindness. In most cases, nodules under the skin form around the adult worms.

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Onchocerciasis, or river blindness, is a neglected tropical disease (NTD) caused by the parasitic worm Onchocerca volvulus. It is transmitted through repeated bites by blackflies of the genus Simulium. The disease is called river blindness because the blackfly that transmits the infection lives and breeds near fast-flowing streams and rivers, mostly near remote rural villages. The infection can result in visual impairment and sometimes blindness. Additionally, onchocerciasis can cause skin disease, including intense itching, rashes, or nodules under the skin. Worldwide onchocerciasis is second only to trachoma as an infectious cause of blindness.

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The recommended treatment is ivermectin which will need to be given every 6 months for the life span of the adult worms (i.e., 10–15 years) or for as long as the infected person has evidence of skin or eye infection.  Ivermectin kills the larvae and prevents them from causing damage but it does not kill the adults

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It is transmitted through repeated bites by blackflies of the genus Simulium.   The people most at risk for acquiring onchocerciasis are those who live or work near streams or rivers where there are Simulium blackflies. Most of the areas where the blackflies are found are rural agricultural areas in sub-Saharan Africa in the countries mentioned previously

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The agent of river blindness, Onchocerca volvulus, occurs mainly in Africa, with additional foci in Latin America and the Middle East.

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There is no vaccine or medication to prevent infection with O. volvulus.
Between 1974 and 2002, disease caused by onchocerciasis was brought under control in West Africa through the work of the Onchocerciasis Control Programme (OCP), using mainly the spraying of insecticides against blackfly larvae (vector control) by helicopters and airplanes. This has been supplemented by large-scale distribution of ivermectin since 1989.The OCP relieved 40 million people from infection, prevented blindness in 600 000 people, and ensured that 18 million children were born free from the threat of the disease and blindness. In addition, 25 million hectares of abandoned arable land were reclaimed for settlement and agricultural production, capable of feeding 17 million people annually.
The African Programme for Onchocerciasis Control (APOC) was launched in 1995 with the objective of controlling onchocerciasis in the remaining endemic countries in Africa and closed at the end of 2015 after beginning the transition to onchocerciasis elimination. Its main strategy has been the establishment of sustainable community-directed treatment with ivermectin (CDTI) and vector control with environmentally-safe methods where appropriate