External ophthalmomyiasis
manifesting with kerato-uveitis
Published in International Ophthalmology
Sonia Attia, MD
Sana Khochtali, MD
Nesrine Abroug, MD
Moncef Khairallah, MD
Department of ophthalmology
Fattouma Bourguiba University Hospital
Faculty of Medicine,University of Monastir
Monastir, Tunisia
Ocular History
A 77 year-old healthy man, living in a
rural region
 Painful red, foreign body sensation and
photophobia of the right eye of 4-days
duration

First Presentation





Visual acuity OD counting fingers, OS 20/63
Congested conjunctiva
diffuse corneal edema associated with subepithelial numerous
linear opacities
2+ aqueous flare and 1+ cells
granulomatous corneal precipitates
First Presentation
Intraocular pressure was normal
bilaterally
 Bilateral nuclear sclerotic cataract
 Fundus examination was
unremarkable in both eyes

Initial diagnosis and treatment


A diagnosis of presumed herpetic keratouveitis
was made
The patient was treated with a combination of
topical ganciclovir 5 times/ day and topical
dexamethasone 6 times/day .
Follow-up

One day later

Slit lamp examination  an approximately 1-mmlong, translucent, light-sensitive, rapidly moving
maggot on the conjunctiva, under the upper lid, and
on the corneal surface
Final Diagnosis
larvae of Oestrus ovis
External Ophthalmomyiasis
manifesting with Keratouveitis
Outcome
Following removal of the maggot and
instillation of tobramycin, the symptoms
completely resolved within 2 days
Conclusion


External ophthalmomyiais usually manifests
with ocular surface involvement
This diagnosis as an uncommon condition must
be considered in the differential diagnosis of
keratouveitis especially in rural areas