Presenting Author: Dr. Kshitij M Parekh, Resident: Dr. Vasantrao Pawar Medical College, Guide: Dr. Dhiraj Balwir, Associate Professor: Dr. Vasantrao Pawar Medical College
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Orbital Myiasis
1. Presenting Author: Dr. Kshitij M Parekh
Resident, Dr. Vasantrao Pawar Medical College
Guide: Dr. Dhiraj Balwir
Associate Professor
Dr. Vasantrao Pawar Medical College
3. A maggot is the larva of a fly (order Diptera);
most commonly the larvae of Brachyceran flies,
such as houseflies, cheese flies, and blowflies.
‘Myia’ is a Greek word meaning ‘fly’. ‘Myiasis’ is
a condition caused by infestation of the body by
maggots. We report a case of orbital myiasis of
the eyelid.
Ophthalmomyiasis progresses rapidly and can
completely destroy orbital tissues within days.
It also destroys the bony tissues extending the
infection to the brain.
4. A female Hausabai Bhor, 75 years old with
complaints of pain and feeling of some
moving object in the left eye of 5 days
duration.
One month before she had a history of dog
bite on the left eye.
She did not receive any treatment prior.
5. On ocular examination
The patient was having visual acuity 6/9 in both eyes.
She had a lacerated wound over both the eyelids of
the left eye.
There was severe degree edema and derangement of
the anatomical configuration of upper eyelid.
The wound was filled with pus.
The nasal bridge was also damaged
Lacrimal sac was missing.
The conjunctiva was congested.
Cornea showed mild edema.
Ocular movements were normal.
The right eye was normal
6. CT-scan reports showed intact bony walls of
the left orbit.
Hemogram showed mild leucocytosis.
Surgical debridement under local anesthesia
was done.
The larvae were removed with the help of
forceps after instilling turpentine oil..
7. The pus and exudates were cleared off till the
healthy tissue was reached.
On removal of the pus from the wound the black
headed larvae were seen.
Turpentine oil forced the aerobic larvae to surface
for air, at which time they could be captured by
forceps.
Utmost care was taken to remove each of the larvae
completely so as to prevent foreign body reaction.
Additionally, lidocaine was injected into the floor of
the cavity
After 3 days the wound was free of larvae and started
healing.
8. Around 15-20 larvae were captured and the
wound was filled with 10% povidine iodine
solution.
Intravenous cefotaxime 1gm b.d. was
started.
Tetanus immunization was done.
Fresh granulation tissue started appearing.
The edema subsided gradually by the 7th day.
There was complete resolution of the
oedema by the 15th day.
The wound healed by secondary intention.
9. No delay should be done in case of treating the
open wound and it should be covered to prevent
access to flies.
Wound should be properly managed post-
operatively with antiseptic dressings and
antibiotics..
There is no absolute method for protection
against myiasis.
Adequate personal hygiene and proper care of
wounds helps to a large extent in preventing this
catastrophe.
Treatment of debilitating underlying conditions if
any needs specific attention.