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.
๏ โMyiaโ is a Greek word meaning โflyโ. โMyiasisโ 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.