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| CASE REPORT |
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| Year : 1990 | Volume
: 38
| Issue : 4 | Page : 187-188 |
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Orbital myiasis-A case report
DC Agarwal, Bhupinder Singh
Dept. of Ophthalmology Medical College, Amritsar, India
Correspondence Address:
D C Agarwal
Dept. of Ophthalmology Medical College, Amritsar
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 2086474 
A case of basal cell carcinoma presenting in an unusual manner as orbital myiasis is reported. Orbit was full of maggots. Histopathology examination from the margin of the ulcerative area confirmed the diagnosis of basal cell carcinoma, which was infested secondarily with larvae of flies. Turpentine oil packs were used to remove the maggots.
How to cite this article:
Agarwal D C, Singh B. Orbital myiasis-A case report. Indian J Ophthalmol 1990;38:187-8 |
| Introduction | |  |
Invasion of the eye and orbit by larvae of flies is common in tropical countries and those with low standards of hygiene. Human ocular myiasis was first reported by Keyt [1] in 1900 and later on from India by Elliot [2] in 1910. The adult flies are not parasitic but their larvae may lay eggs by parthenogenesis which develop into future larvae and increase the destruction of tissues. The most common parasite affecting the eye and orbit is larva of hypoderma bovis which infests cattle. More rarely it may be infested by wohlphartia magnifica, callitroga macel laria and many other flies. [3]
The larvae can penetrate even the intact skin and conjuctival mucous membrane. Infestation occurs by contaminated fingers of the patient after handling the infested cattle or the fly itself. Beneath the skin the larvae start eating the tissue and grow into large maggots. [4]
| Case report | | |
The patient, a 70 year old female was admitted to the hospital on Oct. 13, 1988 with a bandage on her left eye. She complained of severe pain and bleeding from her left eye.
EXAMINATION
There was a brown, fleshy, ulcerated, foul smelling mass all around the left orbit [Figure - 1]. There were a large number of maggots crawling over the fleshy mass. Maggots were white and shiny. One end was blunt and the other sharp [Figure - 2]. Ocular structure were completely eaten up with total visual loss.
HISTOPATHOLOGY EXAMINATION Histopathological examination of the margin of the ulcerated tissue was done. It was diagnosed as a case of basal cell carcinoma infested secondarily with larvae of flies.
TREATMENT
The maggots which were crawling over the surface of the mass were removed manually. Turpentine oil packing was applied. About 100 maggots were removed from the orbit.
Orbit was irrigated with potassium permanganate solution to combat the foul smell. Sterile dressings were applied and systemic antiobiotics were given along with analgesics. After about an hour the patient was comfortable and within two or three days the orbital wound began to heal.
| Discussion | | |
Symptoms and signs were typical of the disease and there was no difficulty in diagnosis. Bleeding occured because of the extensive damage caused by larvae. With turpentine oil packing the maggots came out of the deeper tissues and thus could be removed easily. Radiotherapy was given to the patient for treatment of basal cell carcinoma. Because of the paucity of reports and a few rare features observed this case is reported.
SUMMARY
A case of orbital myiasis is reported with tolet destruction of the eye and other orbital contents.
| References | | |
| 1. | Keyt. F.T. (1900). Quoted by: Sivaramasubramanyam P. Sadanand A.V. Opthalmomyiasis. Brit. J. Ophthal. 52:64, 1968.  |
| 2. | Elliot, R.H. (1910) Quoted by : Sivaramasubramanyam P, Sadanand A.V. : Opthalmomyiasis. Brit. J. Ophthal. 5264, 1968. |
| 3. | Duke Elder S. (9174). "System of Ophthalmology", Vol. VIII. Part I, P 426. Henry Kimpton, London. |
| 4. | Mathur S.P. Makhija J. M : Invasion of the orbit by maggots. Brit. J Ophthal. 51:406,1967. |
[Figure - 1], [Figure - 2]
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