A 41-YEAR-OLD herdsman noted sudden onset of blurred vision with pale,
off-yellow–colored lines crisscrossing his left central visual field
(Figure 1). Faint curvilinear gray-white
lines at the level of the retinal pigment epithelium crisscrossed the left
posterior pole (Figure 2). Temporal
to the macula a 3-mm-long segmented organism, tapered at both ends, was seen
in the subretinal space (Figure 3).
The organism was tentatively identified as the larval form (maggot) of a fly
belonging to the species Cuterebra (C. Lamar Meek,
PhD, oral communication, May 3, 2000). After several hours the larva had moved,
seemingly by reversing its direction, inferior to the optic disc, where it
was destroyed by laser photocoagulation (Figure 4). An intraocular inflammatory reaction developed but subsided
quickly with the topical administration of steroids and cycloplegics. As the
posterior tracks disappeared giving way to macular pigment mottling, the vision
gradually improved but did not return to normal. More peripheral tracks remained
and became partially pigmented (Figure 5).
Several of the tracks converged toward a chorioretinal scar near the temporal
Buettner H. Ophthalmomyiasis Interna. Arch Ophthalmol. 2002;120(11):1598–1599. doi:10.1001/archopht.120.11.1598
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