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OPHTHALMOMYIASIS INTERNA WITH INVASION OF THE OPTIC NERVE
Asad F Durrani1, Mark W Johnson
1Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Purpose:
To report a case of ophthalmomyiasis interna with optic nerve invasion that was treated with oral ivermectin and prednisone.
Methods:
Case report with retrospective review of medical records and multimodal imaging studies.
Results:
A Christmas tree farmer in his sixties presented with expanding multicolored, spiraling photopsias in the left eye. The visual acuity measured 20/50, and examination and imaging findings showed subretinal tracks consistent with ophthalmomyiasis interna. After several weeks of spontaneous improvement, the visual acuity decreased to 20/150 and fundus examination showed new optic disc edema that was treated with ivermectin and prednisone. Despite the development of optic disc pallor, the visual acuity improved to 20/25.
Conclusion:
Subretinal fly larvae can occasionally exit the eye by invading the optic nerve. Treatment of optic nerve involvement with ivermectin and prednisone can result in an excellent visual outcome.
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