Topical ivermectin in ophthalmomyiasis: Literature review and a case report

Abstract

Ocular myiasis is a rare condition affecting orbital and ocular tissues infected by fly larvae of the order Diptera. This clinical case report highlights the importance and requirement of topical ivermectin eye drops for treating external ophthalmomyiasis. A 55-year-old female patient presented to the hospital who had a history of worms in her right eye in the last 6 months and was diagnosed with right eye external ocular myiasis. Mechanical removal of worms done under topical anesthesia and treated with oral tablet ivermectin 12 mg stat, ivermectin topical drops prepared by dissolving ivermectin 12 mg tablet in 10 ml distilled water and advised to instill four times a day, and oral tablet metronidazole 400 mg twice a day for 5 days. The patient effectively responded to the treatment with complete resolution and there was no recurrence. The treatment modality of ophthalmomyiasis depends on the clinical presentation and severity of tissue destruction and is planned on an individual patient basis. Mechanical debridement of worms under topical anesthesia with adjuvant oral ivermectin is recommended. Topical ivermectin eye drops can be used to kill the worms in places where they cannot be manually reached. Further studies are needed to study the efficacy of topical ivermectin.

Keywords

• external ophthalmomyiasis
• maggots
• oral ivermectin
• topical ivermectin