Female Onchocerca volvolus worms live in nodules under the skin for approximately 15 years, where they produce microfilariae that can survive for up to 2 years. The microfilariae are ingested by blackflies and can cause onchocerciasis, also known as river blindness, a disease mainly found in parts of Africa and Latin America that can lead to blindness. Diagnosis involves examining skin snips or biopsies under a microscope for the presence of microfilariae or adult worms.