Ophtalmomyiasis Externa Severe Eye Trauma:A Case Report

Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. This article reports a case of ophthalmomyiasis externa caused by flesh-fly larvae (Sarcophagidae) in a middle-aged Caucasian male of no fixed abode with alcohol dependance, living in the central Europe.The patient presented with acute symptoms in both eyes, complicated with spreading infection to the nasopharynx and numerous skin wounds. Despite the early diagnosis, mechanical removal of the numerous larvae from conjunctival fornices of both eyes under topical anaesthesia, and local and general treatment, the damage to both eyes was extensive. The left eye globe was removed by enucleation and the healing process of the right eye was accompanied by pseudomembrane formation over the cornea and deep neovascularization inside the cornea. The diagnosis is based on direct evidence using a slit lamp and can be confirmed and specified by parasitological investigations. Standard therapy consists of manual removal of the larvae with wound disinfection, followed by debridement in cases where necrotic tissue still remains. Successs, however, is very time dependant, and patients may present with irreversible sight loss.

Keywords: Ophtalmomyiasis externa; flesh-fly larvae; cornea.