Awan H R.
External Ophthalmomyiasis: A Case Report and Review of Management.
Pak J Ophthalmol Jan ;12(2):59-60.

A case report of an 85-year-old debilitated woman with advanced orbital myiasis in basal cell carcinoma is presented. External ophthalmomyiasis is discussed and management is reviewed.

CASE REPORT An 85-year-old woman was referred to the Ophthalmic Plastic and Orbit Unit at AI-Shifa Eye Hospital, Rawalpindi from the nearby Naval Hospital. She complained of pain and loss of vision in her left eye for the last one year. She was clinically anemic and debilitated. Five years ago she developed a nodular lesion involving the left lower lid. This was excised and was followed by radiotherapy two years ago. Histopathology revealed the lesion to be basal cell carcinoma. The right eye had cataract surgery two and a half years ago. The right eye had a corrected visual acuity of 6/36 with corneal opacities. Her intraocular pressure was 16 mmHg. The left orbit was infested with maggots. The lids and the orbital tissues had been devoured by the larvae and all that was left was a phthisical eyeball containing maggots. The larvae had invaded all her paransal sinuses on the left side. Some were burrowing into the cranium through the left frontal sinus. X-rays of the skull and paranasal sinuses were taken, which demonstrated invasion of the sinuses and erosion of the roof of the orbit. A maggot oil dressing was applied to the left orbit every five to ten minutes and the larvae picked up by a pair of forceps. Forty maggots were removed from the orbit and the exposed sinuses. The patient was referred to the neurosurgeon. She died two days later. The entomologist identified the larvae as Chrysomia megacephala.

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