Internal Ophthalmomyiasis and Treatment by Laser Photocoagulation: A Case Report

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  • Iowa Department of Public Health, McFarland Clinic PC, Entomology Department, Iowa State University, Des Moines, Iowa

The clinical diagnosis, treatment management, and epidemiology of a case of unilateral posterior ophthalmomyiasis in a university farm manager are reported. Subretinal tracking was prominent, leading to vision abnormalities, which initially prompted the patient to seek medical evaluation. Identification of the organism based on study of photographs was judged to be a first-instar larva of a Cuterebra (rodent bot fly), although identification of first-instar (stage) myiasis-producing fly larvae is impossible. Inasmuch as the patient was a herdsman, it is likely that the larva is of the genus Hypoderma (cattle grub) or possibly Gasterophilus (horse bot). Laser treatment was effectively used to destroy and immobilize the organism. Subsequently, the patient's health remains satisfactory, and his vision has improved. This case is reported to confirm increasing frequency of ophthalmomyiasis and to improve awareness of its features. Early recognition of this condition, when tumors and other conditions remain suspect, would preclude unnecessarily invasive surgical procedures, including enucleation.