Korean J Ophthalmol.  2013 Oct;27(5):341-344. 10.3341/kjo.2013.27.5.341.

External Ophthalmomyiasis Presenting to an Emergency Department: Corneal Findings as a Sign of Oestrus ovis

• Gholamhossein Y
• Behrouz H

• KMID: 1707287
• DOI: http://doi.org/10.3341/kjo.2013.27.5.341

Abstract

PURPOSE
This study aims to determine the frequency of opthalmyomyiasis externa and the ocular findings of disease in Southern Khorasan.
METHODS
All patients referred to the emergency department of Valiaser hospital during the year 2011 with external ophthalmomyiasis were enrolled in this study. The diagnosis of external ophthalmomyiasis was made according to clinical findings and the presence of Oestrus ovis larvae.
RESULTS
There were 18 cases of external ophthalmomyiasis in the emergency department of Valiaser hospital in 2011. Most cases had the common signs and symptoms of allergic conjunctivitis, except for three males who were referred with respective complaints of red eye, foreign body sensation, and swelling around the eyelids after contact injury the previous day; corneal infiltration was present in three cases. The visual acuity among the three cases that had peripheral corneal involvement was 20 / 30 in both eyes. The bulbar conjunctiva showed chemosis in all cases and a ropy pattern discharge that was clinically compatible with external ophthalmomyiasis. However, in one case, microscopic slit lamp examination did not show Oestrus ovis larvae.
CONCLUSIONS
The frequency of external ophthalmomyiasis was high in this region. Although external ophthalmomyiasis usually manifests as allergic conjunctivitis, coronary-like corneal infiltration may be considered in the differential diagnosis of external ophthalmomyiasis or toxic insult.

Keyword

Corneal infiltration; Epidemiology; External ophthalmomyiasis; Oestrus ovis

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Animals
Cornea/parasitology/*pathology
Diagnosis, Differential
*Diptera
*Emergency Service, Hospital
Eye Infections, Parasitic/*diagnosis/epidemiology/parasitology
Female
Humans
Incidence
Iran/epidemiology
Larva
Male
Middle Aged
Myiasis/*diagnosis/epidemiology/parasitology
Retrospective Studies
Young Adult

Figure

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  Fig. 1 The first case. Circumb-limbal corneal infilteraton. (A) Superior cornea infiltration. (B) Inferior cornea infiltration and conjunctival chemosis (arrow). (C) Sever conjunctival edema and infiltration (superior arrow) and ropy pattern discharge (inferior arrow). (D) Magnified corneal infilteraton.

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  Fig. 2 The second case. (A) The superior peripheral corneal infilteration. (B) Heavy ropy pattern discharge (arrow). (C) Clear cornea centeraly (arrow). (D) Fine ropy pattern discharge (arrow).

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  Fig. 3 The thired case. (A) Superior corneal infilteration. (B) Inferior corneal infilteration. (C) Lived Oestrus ovis in conjunctiva. (D) Dead Oestrus ovis in lid (arrow).

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  Fig. 4 (A,B) The whole larva with translucent segmented body and large dark oral hooks connected to a cephalopharyngeal skeleton (arrow). (C,D) Magnified view will showing the anterior part of the dead maggot with a pair of dark oral hooks (arrow).

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