Ophthalmomyiasis Externa: A Report of Three Cases

Abstract

Three patients were admitted to our clinic with symptoms of conjunctivitis. On ocular examination, moving larvae were seen in the conjunctival sac. All of the larvae were immobilized by topical cyclopentolate and removed mechanically under topical anesthesia. The patients healed without any complications after the treatment. Physicians should consider ophthalmomyiasis externa in patients presenting with similar symptoms, especially in areas with high numbers of livestock. Otherwise the diagnosis can be missed.

Ophthalmomyiasis Externa and Importance of Risk Factors, Clinical Manifestations, and Diagnosis: Review of the Medical Literature

“…In the past decade, there have been reported cases of this infection in countries where autochthonous cases were previously unknown, such as the Czech Republic [46], Bulgaria [47], Australia [48], China [49], Serbia [19], Jamaica [50], South Africa [51], Morocco [52], Japan [53], Indonesia [54], Canada [55], Barbados [56], Belgium [57], Iraq [58], United Kingdom [59], Honduras [60], and Bolivia [61]. Despite its global prevalence [10,18], most reported cases are still concentrated in India [2,27,29,37,[62][63][64][65][66][67], Turkey [25,28,43,[68][69][70][71][72][73][74], Iran [20,40,75], and Libya [18,76].…”

“…Turkey ranks third in the world in the number of reported cases. Various studies have reported case numbers ranging from one to twelve [25,26,29,43,[68][69][70][71][72][73][89][90][91][92], with the causative agent predominantly being O. ovis and C. bezziana in only one case [89]. Interestingly, cases have occurred more frequently in urban areas without known animal contact.…”

“…External ophthalmomyiasis cases have been reported across Asia, Europe, and South America from 2000 to 2022, with a high incidence in countries such as India [2,27,29,37,[62][63][64][65][66][67]79], Jordan [42,88], Turkey [25,29,43,[68][69][70][71][72][73][74], Iran [20,40,75], and Brazil [17,19,93,94]. As shown in Table 1, the geographical distribution of the flies responsible for this disease is mainly in warm and humid tropical or subtropical areas ideal for fly breeding [10].…”

“…Ophthalmomyiasis is not a minor disease and poses a significant public health concern, especially in developing countries such as India [5,27,29,37,38,[62][63][64][65][66][67]79], Jordan [42,88], and Turkey [25,26,28,68,69,72,[89][90][91][92]144]. However, the larvae responsible for this disease are often discarded without proper examination [10], leading to inadequate case recording.…”

External Ophthalmomyiasis Caused by Oestrus Ovis

“…Irrigation of ocular surface is usually insufficient because larvae can attach the mucosa firmly with their hooks (7). Prior application of topical cyclopentolate or topical ivermectin is reported to immobilize or kill larvae and facilitate their mechanical removal (10,11). Anti-inflammatory drugs are prescribed to control host reaction and antibiotics against secondary infections.…”