Ocular Myiasis.

PRESENTATION

A 38-year-old farmer presented to the emergency with a 2-day history of foreign body sensation and discharge in his left eye after manure fell into his eye. His visual acuity was 20/20. On examination, lids were edematous, conjunctiva congested, and cornea was clear. A maggot was seen on the upper palpebral conjunctiva [Figure 1a], which was removed with a forceps after instillation of topical anesthetic. Entomological assessment found it to be a larva of early stage of the house fly of the order Diptera and genus Musca. It had two distinct black suckers on the head, no distinct limbs and a tapering body [Figure 1b]. He was given topical moxifloxacin and lubricants 4 times/day for a week after which his symptoms were relieved.

Figure 1

(a) Maggot on the upper lateral portion of the palpebral conjunctiva (b) anatomical morphology of the maggot.

DISCUSSION

Ocular myiasis refers to infestations of the eye and/or ocular adnexa by larvae of the order Diptera and represents <5% of the cases of human myiasis.[1] It is divided into orbital, internal or external, based on site of larval infestation. Clinical manifestations may be varied depending upon location of the larvae. External ocular myiasis refers to superficial infestation of ocular tissue, including conjunctiva as was seen in our case.[2]

Maggots/larvae in eye are rare in both developed and in developing nations due to awareness and relatively easy access to ophthalmic facility as compared to the past. However, this entity is still present and sometimes even a general physician can come across such situation.

Except mechanical removal of these larvae, no other treatment has been described. However, topical application of anesthetic drops is said to paralyze the maggots, thus facilitating their removal.[2]

Financial Support and Sponsorship

None.

Conflicts of Interest

There are no conflicts of interest.