Ophthalmomyiasis externa due to oestrus ovis

Ophthalmomyiasis externa (OE) is infestation of external ocular structures with larvae/maggots. Oestrus ovis (sheep botfly) is the most common cause of human ophthalmomyiasis among the other species.[1] A 24-year-old male presented with ocular irritation, foreign body sensation, pain, redness, and hyperlacrimation in his right eye since alleged history of colliding with a cobweb a few hours ago. On examination, numerous transparent, black-headed larvae were seen swarming over the ocular surface [Fig. 1a and b]. Twenty-five larvae were manually removed using cotton-tipped buds under topical anesthesia with 0.5% proparacaine, which was curative. Microscopy showed tapering at the head and posterior ends and two black oral hooks on the head and spines on posterior segment, suggestive of first instar (L1) larva of Oestrus ovis [Fig. 1c]. The patient was asymptomatic, and the ocular surface was clear of larvae on follow-up.Figure 1: (a) Slit lamp photograph showing black-headed transparent larvae of Oestrus ovis swarming on palpebral conjunctiva. (b) Slit lamp photograph showing larvae swarming over the lower lid margin near the punctum region. (c) Magnified view of larvae under a scanning microscope showing two black oral hooks on the head and spines on posterior segment, suggestive of first instar (L1) larva of Oestrus ovisThe report highlights that Oestrus ovis can cause OE after seemingly innocuous trauma. Manual removal of larvae was therapeutic.[2] Early intervention is crucial to prevent internal migration of larvae and sight-threatening complications. Authors’ contributions MJ and RA collected clinical details of the patient. MJ, RA and SA were involved in the clinical care of the patient. MJ prepared the first manuscript of the report. All authors reviewed and refined the manuscript for intellectual content. The final submission was seen and reviewed by all authors prior to submission. Declaration of patient consent The author certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in this journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.