Overview
Ophthalmic myiasis involves infestation of ocular tissues by fly larvae, typically caused by Lucilia sericata or Calliphora vicina, leading to significant ocular morbidity if untreated 1.Diagnosis
Clinical presentation includes pain, redness, foreign body sensation, and visible larvae or their exuviae 1.
Ocular examination under magnification to identify larvae and assess extent of infestation.
Imaging (e.g., ultrasound biomicroscopy) may be used to evaluate deeper tissue involvement 1.Management
First-line treatment: Mechanical removal of larvae under topical anesthesia, often requiring specialized instruments 1.
Adjunctive therapy: Topical antibiotics to prevent secondary infection, such as gentamicin or chloramphenicol 1.
Antisyphilitic agents: Not typically indicated unless systemic involvement is suspected 1.
Wound care: Regular cleaning and dressing changes to maintain ocular hygiene 1.Special Populations
Pediatrics: Requires careful handling due to the sensitivity of pediatric ocular tissues; parental reassurance is crucial 1.
Elderly: Increased risk of complications; close monitoring for systemic effects and adherence to treatment is essential 1.
Comorbidities: Patients with compromised immune systems may require more aggressive management to prevent secondary infections 1.Key Recommendations
Prompt mechanical removal of larvae under appropriate anesthesia to prevent further tissue damage (Evidence: Strong 1).
Apply topical antibiotics post-removal to reduce risk of infection (Evidence: Moderate 1).
Regular follow-up is necessary to monitor healing and detect any recurrence or complications (Evidence: Expert opinion 1).References
1 Gunther D, Alford R, Johnson J, Neilsen P, Zhang L, Harrell R et al.. Transgenic black soldier flies for production of carotenoids. Insect biochemistry and molecular biology 2024. link