External ophthalmomyiasis: Slither sign in orb

Ophthalmomyiasis is the myiasis of the eye, a relatively rare condition characterized by infestation of ocular and orbital tissues with fly larvae. Oestrus ovis being the most common causative organism. It typically occurs in shepherds and farmers in rural areas. The clinical symptoms depend on the extent of tissue invasion, which may include conjunctivitis, haemorrhage or ulceration. We report a case of 20 y/M who presented to us with foreign body sensation and watering in right eye since morning, and redness since 1 day. His visual acuity in right eye was 6/9 and in left eye was 6/6. On slit lamp examination, anterior segment of right eye revealed lid oedema, mucopurulent discharge, papillae, conjunctival congestion and moving larvae about 15-20 in number were seen on cornea and conjunctiva. Rest was unremarkable. Causative larvae were removed with forceps under topical anaesthesia followed by instillation of antibiotic eyedrop. The causative larvae were sent for microbiological examination and were identified as the first stage larvae of Oestrus ovis, the sheep nasal bot fly. Very few cases of external ophthalmomyiasis have been reported from urban areas of Maharashtra in India.