Ophthalmomyiasis interna posterior. Report of a case with optic atrophy

The prognosis for patients with ophthalmomyiasis Interna posterior is variable. In many patients the larva remains in the eye for years without inducing inflammation or loss of vision. Sometimes, however, the migrating larva involves the macula and optic nerve and results in permanent visual loss or even blindness.

Our patient presented with sudden painless loss of vision in the right eye that was caused by ophthalmomyiasis interna posterior. Hemorrhage of the optic nerve head suggested that the fly larva had entered the vitreous cavity from the optic nerve head. Subretinal tracts were sequelae of the subretinal migration of the organism. Sequential photographs documented the fly larva migration into the optic nerve head head from the vitreous cavity. The organism was removed by pars plana vitrectomy and retinectomy.

In spite of the successful removal of the first stage fly larva, the visual acuity remained poor because of optic nerve atrophy.

We suggest early removal of fly larvae to prevent damage and visual loss in cases of ocular myiasis interna posterior.