External ophthalmomyiasis: A case report

Myiasis, derived from the Greek word “myia” meaning “fly,” refers to infestation by fly larvae, with ophthalmomyiasis denoting larval invasion of the eye in external (ocular surface), internal (intraocular), or orbital forms; external cases, like the one presented here, confine larvae to the conjunctiva. A patient experienced an accidental fly encounter while driving, rapidly developing severe conjunctivitis characterized by intense redness, swelling, foreign body sensation, photophobia, and tearing. Slit-lamp examination revealed multiple creamy-white, mobile larvae (likely from Oestrus ovis , common in India) in the conjunctival fornix; prompt mechanical removal using forceps after topical anesthesia and saline irrigation, followed by topical antibiotics (e.g., moxifloxacin), steroids, and cycloplegics, led to dramatic symptom resolution by the next follow-up, highlighting the efficacy of conservative management in preventing complications like corneal ulcers while underscoring prevention through eyewear and repellents in fly-prone areas.