[SavageGlow]

A 72-year-old male patient presented to the emergency department on October 31, 2015, with a complaint of repeated pain for two years after trauma to his right eyelid and a 2-day history of symptoms aggravated by the wriggling out of larvae. The patient reported that his right upper lid had been injured by cane leaves 2 years prior, but no treatment was received. Then, he experienced repeated pain in his right eye, accompanied by gradually decreased vision until it was completely lost 1 year previously. His painful symptoms worsened 2 days before presentation, with bleeding, a crawling sensation and larvae wriggling out (Fig. 1). He denied a history of alcoholism, previous ocular surgery, or prolonged use of medications.

On ophthalmic examination, the visual acuity test revealed no light perception in his right eye. His right periorbital skin was red and edematous, and the eyelid was thickened. There was a large eyelid wound of approximately 4 cm ∗ 1 cm filled with numerous white larvae, some of which were crawling out.

Considering potential infections, the patient received topical levofloxacin eye drops, intravenous ceftazidime and levofloxacin, and a tetanus antitoxin injection. In view of imaging evidence of total destruction of the globe caused by infiltration of the larvae, exenteration of the right orbit was performed in the patient. All necrotic tissues and nearly 100 larvae were removed.

On the ninth postoperative day, the defect was repaired via reconstruction with a pedicled musculocutaneous flap from the forehead region (Fig. 3). The patient recovered well postoperatively and was discharged uneventfully. During the 6-month follow-up period, the wound healed well, and the patient had no further complaints. Subsequently, he was lost to follow-up.

The histopathological examination of the orbital contents revealed hyperplastic inflammatory granulation tissue, large areas of necrotic tissue and acute inflammatory exudates. The larvae were identified as the larvae of Lucilia sericata (Diptera: Calliphoridae) (Fig.4A and B).

[Mr.NoCredit]

Dr. Doom.

Those square eye holes..

[shadowstein]

Myiasis in my-eye-asis

[Elizabeth76]

Nasty. No way, I'd absolutely lose it knowing there were maggots eating away at any of my body part. How did this guy sleep after feeling wriggling, let alone 2 days without getting help?