External ophthalmomyiasis due to Oestrus ovis

Parthopratim Dutta Majumder; Pankaj Jeswani; Narayanaperumal Jeyathilakan; Jyotirmay Biswas

doi:10.4103/ijo.IJO_1391_18

Users Online: 870

PHOTO ESSAY

Year : 2019 | Volume : 67 | Issue : 3 | Page : 404-405

External ophthalmomyiasis due to Oestrus ovis

Parthopratim Dutta Majumder¹, Pankaj Jeswani¹, Narayanaperumal Jeyathilakan², Jyotirmay Biswas¹
¹ Department of Uvea Medical and Vision Research Foundations, Sankara Nethralaya, 18, College Road, Nungambakkam, Tamil Nadu, India
² Madras Veterinary College, Vepery, Chennai, Tamil Nadu, India

Date of Submission	28-Aug-2018
Date of Acceptance	22-Oct-2018
Date of Web Publication	18-Feb-2019

Correspondence Address:
Dr. Parthopratim Dutta Majumder
Department of Uvea, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai - 600 006, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/ijo.IJO_1391_18

Abstract

Keywords: Conjunctivitis, external ophthalmomyiasis, Oestrus ovis

How to cite this article:
Dutta Majumder P, Jeswani P, Jeyathilakan N, Biswas J. External ophthalmomyiasis due to Oestrus ovis. Indian J Ophthalmol 2019;67:404-5

How to cite this URL:
Dutta Majumder P, Jeswani P, Jeyathilakan N, Biswas J. External ophthalmomyiasis due to Oestrus ovis. Indian J Ophthalmol [serial online] 2019 [cited 2019 Dec 7];67:404-5. Available from: http://www.ijo.in/text.asp?2019/67/3/404/252411

Case Report

A 58-year-old male presented with redness and irritation in the right eye for a week. His best-corrected visual acuity (BCVA) was 6/6 in both eyes. He denied any history of foreign body entry into the eye, contact with livestock or recent history of swimming. Slit-lamp examination of the right eye revealed hyperemia of the bulbar and palpebral conjunctiva, quiet anterior chamber and a clear cornea. There were multiple spindle-shaped translucent larvae wriggling over bulbar conjunctiva and tarsal conjunctiva [Figure 1]a. They were trying to disappear towards fornices on shining the slit-lamp light. Under slit-lamp, total eight larvae were removed with the help of forceps under topical anaesthesia. It is worth mentioning was noted that removal with cotton-tipped applicator was not successful as the larvae tend to attach tightly to the conjunctiva. All these larvae were put in normal saline and in 70% alcohol and were sent to laboratory. He was started on a topical anti-microbial agent (ciprofloxacin 0.3%). Microscopic examination revealed spindle-shaped skeleton with a pair of sharply curved fuscous brown oral hooks at the anterior end [Figure 1]b and [Figure 1]c. Based on the morphology, they were identified as first instar larvae of Oestrus ovis.

Figure 1: (a) Slit-lamp photograph (magnified) view of conjunctiva near lateral canthus showing three first instar larvae of Oestrus ovis (b) Microscopic photograph of a first instar larva of Oestrus ovis (c) Anterior end of larva equipped with cephalopharyngeal skeleton showing two large dark sharply curved oral hooks, hypopharyngeal sclerites and elongated rod-shaped pharyngeal sclerites

Click here to view

Discussion

Oestrus ovis, commonly known assheep nasal botfly, is a worldwide parasite that usually infests the nasal cavity and paranasal sinuses of sheep, goats, cattle and horses.^[1] Humans are the accidental hosts and Oestrus ovis larvae have been mainly reported to cause external ophthalmomyiasis by various authors.^[1–3] External ophthalmomyiasis due to Oestrus ovis usually manifests with conjunctivitis-like clinical picture.^[4] These larvae have been reported to cause significant conjunctival eosinophilic infiltrations leading to non-necrotising granulomatous inflammation and eosinophil degranulation which can further lead to epithelial cell damage and goblet cell secretion.^[5] Thus, presentation with itching, foreign body sensation and a watery-mucopurulent discharge is not uncommon and disease can easily be misdiagnosed as conjunctivitis.^[4] Oestrus ovis larvae are unable to penetrate cornea or sclera as they lack the ability to secrete proteolytic enzymes.^[5] However, Oestrus ovis larvae have been reported to present with keratitis^[6] and keratouveitis.^[7] Thus, early removal of the larvae is very important in patients with external ophthalmomyiasis.

Declaration of patient consent

The authors 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 the 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.

References

1.	Özyol P, Özyol E, Sankur F. External ophthalmomyiasis: A case series and review of ophthalmomyiasis in Turkey. Int Ophthalmol 2016;36:887-91.
2.	Velev V, Mikov O. Ophthalmomyiasis caused by larvae of the parasite Oestrus ovis. QJM 2018;111:727-8.
3.	Dunbar J, Cooper B, Hodgetts T, Yskandar H, van Thiel P, Whelan S, et al. An outbreak of human external ophthalmomyiasis due to Oestrus ovis in southern Afghanistan. Clin Infect Dis 2008;46:e124-6.
4.	Akdemir MO, Ozen S. External ophthalmomyiasis caused by Oestrus ovis misdiagnosed as bacterial conjunctivitis. Trop Doct 2013;43:120-3.
5.	Pather S, Botha LM, Hale MJ, Jena-Stuart S. Ophthalmomyiasis Externa: Case report of the clinicopathologic features. Int J Ophthalmic Pathol 2013;2. doi: 10.4172/2324-8599.1000106.
6.	Sreejith RS, Reddy AK, Ganeshpuri SS, Garg P. Oestrus ovis ophthalmomyiasis with keratitis. Indian J Med Microbiol 2010;28:399-402. [PUBMED] [Full text]
7.	Jenzeri S, Ammari W, Attia S, Zaouali S, Babba H, Messaoud R, et al. External ophthalmomyiasis manifesting with keratouveitis. Int Ophthalmol 2009;29:533-5.