Intraocular infestation by the reindeer warble fly larva: an unusual indication for acute vitrectomy

A case of ophthalmomyiasis interna posterior (OIP) caused by the larva of the Reindeer warble fly is reported. The larva was initially found intraretinally in the inferior parts of the fundus. From this position it moved into the macula lutea within two days, causing decreased visual acuity. Acute vitrectomy was performed and the larva was removed through a retinotomy. About two months afterwards a small retinal detachment appeared near the ora serrata, where the larva had entered the eye. The retina was reattached with a scleral buckling procedure. The patient regained most of his vision postoperatively. Pars plana vitrectomy is a safe procedure and we consider that in any case of OIP, with a living larva in the eye, acute vitrectomy should be considered, since the larva may damage vital parts of the eye. Furthermore, the site of entrance should be treated with photocoagulation to prevent retinal detachment.