Ophthalmomyiasis

Ophthalmomyiasis means fly larvae (maggots) invade the eye or the tissues around the eye. It is uncommon, but it can harm vision if it is not treated quickly. Doctors can usually cure it by finding and removing the larvae and by treating any infection or inflammation.

“Ophthalmo” means eye. “Myiasis” means a human or animal body area invaded by fly larvae. So ophthalmomyiasis is a condition where fly eggs hatch into tiny larvae and those larvae live in the eye area. The larvae want moisture, warmth, and protein. They cannot live long on a dry surface. They use tiny hooks and mouth parts to hold on and to feed. They can attach to the eyelids, the conjunctiva (the pink lining), the cornea (the clear front window), the white of the eye, the tear sac, or even deeper spaces inside or behind the eye. Some species only crawl on the surface. Some species can drill into tissue. A few species can enter inside the eyeball and damage the retina or optic nerve. That is why fast care is so important.

People usually get ophthalmomyiasis after a fly lands near the eye and deposits eggs or larvae, or when a larva from a nearby wound or tissue moves toward the eye. Many cases happen in warm, rural areas and in places where livestock, sheep, goats, cattle, or dogs are common. Travelers can also get it. It can also occur in people who cannot protect their eyes well, such as people who are ill, very old, sleeping outdoors, or have poor vision or reduced blinking.

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How the problem happens

A female fly places eggs or live larvae on a host (sometimes on another insect that later drops them). The eggs hatch quickly. The larvae seek moisture and tissue. Around the eye, they stick to the surface with tiny spines and may move in short, jerky steps. Some larvae stay on the outer eye and cause irritation. Other, more aggressive species can burrow into tissue or even into the eyeball. The body reacts with inflammation, swelling, tearing, and sometimes infection. If the larvae reach the inside of the eye, they can trigger uveitis, retinal damage, bleeding, or endophthalmitis, which threaten vision.

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Types of ophthalmomyiasis

Doctors describe types in two easy ways: by location and by the fly’s behavior.

A) By location

1. Ophthalmomyiasis externa (external)
   The larvae are on the surface—on the eyelids, lashes, conjunctiva, or corneal surface. This is the most common type. It causes tearing, redness, itching, pain, and a moving foreign-body feeling.

2. Ophthalmomyiasis interna (internal)
   The larvae are inside the eyeball (anterior chamber, vitreous gel, retina, or choroid). This is rare but dangerous. It can lower vision and may cause floaters, light sensitivity, or severe inflammation. Doctors sometimes split this into anterior (front of the eye) and posterior (back of the eye) forms.

3. Orbital myiasis (around or behind the eye)
   The larvae invade the eyelid tissues, tear sac, or the orbit (the bony cavity behind the eye). This can cause swelling, tissue death (necrosis), foul discharge, and even risk to the eye and brain if severe.

B) By the fly’s biology

4. Obligatory myiasis
   These species must use living tissue to complete their life cycle. They are more destructive.

5. Facultative myiasis
   These species usually live on dead tissue but can invade living tissue, especially in wounds.

6. Accidental myiasis
   The larvae do not “intend” to live in the eye, but accidentally end up there and survive briefly.

Causes

Here “causes” include the larval species and the exposures that place larvae near the eye. Each cause is a clear path that leads to ophthalmomyiasis.

1. Sheep botfly (Oestrus ovis) near the eye
   This fly sprays or drops live larvae that can land on the eye surface, causing external ophthalmomyiasis with sharp irritation.

2. Human botfly (Dermatobia hominis) exposure (Americas)
   This species can use mosquitoes as “couriers.” A mosquito lands on the eyelid, and the botfly larva transfers and later invades tissue.

3. New World screwworm (Cochliomyia hominivorax)
   An obligatory tissue invader. It can burrow into living tissue near the eye and sometimes move toward the orbit.

4. Old World screwworm (Chrysomya bezziana)
   Similar to the New World species but found in Africa, Asia, and the Middle East. It can cause deep tissue damage around the eye.

5. Warble flies (Hypoderma bovis, Hypoderma lineatum)
   Common around cattle. Larvae can migrate in human tissue and rarely reach ocular structures.

6. Flesh flies (Wohlfahrtia magnifica, Sarcophaga spp.)
   These can lay larvae directly on moist tissues. The eye area is a target, especially in warm climates.

7. Blowflies (e.g., Lucilia sericata, Calliphora spp.)
   Often linked to wounds or poor hygiene. They may start in a skin ulcer and spread to the eyelids or tear sac.

8. Housefly relatives that colonize wounds
   Some Muscidae species can lay eggs in soiled dressings or ulcers near the eye, leading to spread.

9. Open eyelid wounds or surgical incisions
   A fresh wound on the lid or near the eye can draw egg-laying flies, starting local myiasis that extends toward the eye.

10. Chronic conjunctivitis with discharge
    Moist discharge can attract flies to the eye surface, especially outdoors, creating a chance for egg or larval deposit.

11. Sleeping outdoors without eye protection
    Nighttime insect contact near the face raises risk of larvae being deposited in or near the eye.

12. Handling livestock and then rubbing eyes
    Contaminated hands can carry eggs or larvae from animal fur or barns to the eyelids or lashes.

13. Travel to endemic rural areas
    Visiting areas with high fly density and livestock increases exposure, especially during rainy seasons.

14. Poor eyelid closure (facial nerve palsy, severe dry eye)
    A partly open eye gives flies easier access to the moist ocular surface.

15. Reduced ability to care for oneself
    Advanced age, frailty, mental health challenges, or substance use can lead to poor hygiene, attracting flies.

16. Immune compromise
    Diabetes, malnutrition, steroids, HIV, or other conditions can weaken defense, making tissue invasion easier.

17. Untreated skin cancers near the eye
    Necrotic tumors or ulcerated lesions in eyelid skin can become larval entry points.

18. Severe sinus or lacrimal sac infection with necrosis
    Dead or dying tissue in the tear drainage area can draw flies, leading to tear-sac or orbital myiasis.

19. Inadequate wound care after facial trauma
    Soiled dressings or dirty wounds can be colonized by larvae and spread toward the eye.

20. Contact lenses worn too long with poor hygiene
    Protein deposits and dryness can irritate the surface and, very rarely, help larvae stick if exposure occurs.

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Symptoms

1. A moving, crawling, or “something in my eye” feeling
   Many patients describe a sudden moving foreign-body sensation that does not stop after blinking.

2. Eye redness
   The eye looks red or bloodshot because of irritation and inflammation.

3. Tearing (watering)
   The eye makes more tears to try to flush out the larvae or debris.

4. Eye pain or stinging
   The tiny hooks on the larva and the inflammation cause sharp or aching pain.

5. Itching or burning
   The irritated surface can itch intensely and may burn.

6. Light sensitivity (photophobia)
   Light can feel too bright because the cornea and inside of the eye are inflamed.

7. Blurred vision
   Swelling, tearing, or corneal injury can make vision foggy. Deeper invasion can lower vision further.

8. Floaters or moving spots
   If larvae reach the vitreous or retina, you may see spots, threads, or shadows that move with the eye.

9. Lid swelling or drooping
   The eyelid can become puffy, tender, and heavy.

10. Thick or foul discharge
    A yellow or smelly discharge suggests secondary infection.

11. Bleeding from the surface
    Scratches or burrowing can lead to small bleeds on the conjunctiva or cornea.

12. Headache or facial pain
    Inflammation can refer pain to the brow, temple, or cheek.

13. Reduced color vision or contrast
    Deeper or internal inflammation can change how you see colors or fine detail.

14. Fever or feeling unwell (sometimes)
    If infection spreads, you can feel sick or feverish.

15. Bad smell from wounds
    Orbital or lid tissue necrosis can produce a strong odor.

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Diagnostic tests

Doctors choose tests based on how deep they think the larvae are, how severe the inflammation is, and how the vision is doing. Below are 20 useful tests, grouped as requested.

A) Physical exam tests

1. Visual acuity test (eye chart)
   You read letters to check how well you see. If vision is reduced, doctors suspect corneal damage, inflammation, or internal involvement. This gives a baseline to track recovery.

2. External inspection and eyelid eversion
   The doctor looks closely at the lids, lashes, and skin, then flips the eyelid to inspect the fornices (hidden pockets). This often reveals surface larvae, abrasions, or discharge. It is quick and important.

3. Slit-lamp biomicroscopy
   A bright microscope lets the doctor examine the conjunctiva, cornea, and anterior chamber in detail. The doctor may see the larvae moving, see scratches, ulcers, or inflammation. This is the key exam for external disease.

4. Pupillary light reflex and RAPD check
   The doctor tests how the pupils react to light and looks for a relative afferent pupillary defect (RAPD). An RAPD suggests optic nerve or severe retinal involvement, which is a warning for internal disease.

5. Ocular motility and orbital palpation
   You move your eyes in all directions while the doctor checks for pain, restriction, or double vision. The doctor gently palpates around the orbit to look for swelling, crepitus, or tenderness—signs of orbital involvement.

B) Manual tests (4)

6. Cotton-tip swab sweep of the fornices
   With topical anesthetic, the doctor sweeps the deep corners of the eyelids to dislodge and collect larvae. This is both diagnostic and therapeutic.

7. Fluorescein staining of the cornea
   A safe orange dye turns bright green under blue light wherever the cornea is scratched or ulcerated. It shows tracks or abrasions made by the larvae and checks for ulcers that need care.

8. Seidel test (leak test) if a corneal wound is suspected
   Fluorescein can also show leaking aqueous fluid if there is a full-thickness corneal hole. A positive Seidel is an emergency.

9. Confrontation visual fields
   A simple bedside check compares your side vision with the examiner’s. Field loss can mean retinal or optic nerve trouble from internal disease.

C) Lab and pathological tests

10. Complete blood count (CBC) with differential
    Doctors check for elevated white cells or eosinophils, which can go up with some parasitic reactions or secondary infection.

11. Swab and culture of discharge
    If there is thick or smelly discharge, a swab can be cultured for bacteria to guide the right antibiotic.

12. Larval identification under a microscope
    The removed larva is examined for shape, mouth parts, and spines to identify the species. Knowing the species helps predict behavior and choose treatment.

13. Histopathology of excised tissue
    If tissue is removed (for example, necrotic eyelid tissue), a pathologist looks for larval parts, inflammation, and tissue death, confirming the diagnosis and checking how deep the invasion goes.

14. Molecular testing (PCR / DNA barcoding) of the larva
    If the species is unclear, genetic testing can confirm the exact fly, which is useful for public health and research.

D) Electrodi

agnostic tests

15. Electroretinography (ERG)
    This test measures electrical responses of the retina to light. If larvae or inflammation affect the retina, the ERG can be reduced or abnormal.

16. Visual evoked potentials (VEP)
    This measures the brain’s response to visual signals. Delayed or reduced signals can mean optic nerve or visual pathway involvement from internal disease.

E) Imaging tests

17. B-scan ocular ultrasonography
    An ultrasound probe on the closed eyelid shows shadows inside the eye. Doctors can see vitreous opacities, intraocular larvae, or membranes, especially when the view is cloudy.

18. Optical coherence tomography (OCT)
    OCT is like a microscopic ultrasound with light. It shows layers of the retina and choroid. Doctors can see tracks, cysts, or inflammatory changes from internal larvae.

19. CT scan of the orbits and sinuses
    CT shows bone and air spaces well. It helps find orbital collections, sinus sources, or bone erosion if myiasis spreads around the eye.

20. MRI of the orbits and brain
    MRI shows soft tissues very clearly. It is useful when doctors suspect deep orbital spread, intracranial extension, or complications not seen on other tests.

Non-pharmacological treatments

These steps are core. Many are done immediately in clinic. They remove larvae, protect the eye, and help it heal.

1. Instant eye protection: place a clean shield and avoid rubbing. Purpose: prevent further injury. Mechanism: blocks mechanical trauma and stops larvae from moving deeper.

2. Topical anesthetic in clinic (procedural aid): numbs the eye for safe removal. Purpose: comfort and stillness. Mechanism: stabilizes the surface so larvae can be grasped precisely.

3. Eyelid eversion and deep fornix sweep: a careful manual sweep of hidden spaces. Purpose: find every larva. Mechanism: mechanical dislodgement.

4. Forceps extraction under slit lamp: the key step. Purpose: complete removal. Mechanism: direct grasp of the larva’s body or head as it surfaces.

5. Copious sterile irrigation: washes away debris and helps float out small fragments. Purpose: reduce irritants and microbes. Mechanism: dilution and physical removal.

6. Ophthalmic ointment “smother and coax” technique: thick lubricating eye ointment (not petrol or home chemicals) can make larvae detach and migrate outward. Purpose: easier removal. Mechanism: reduces oxygen and makes the surface slippery.

7. Debridement of necrotic tissue (eyelid/wound): careful removal of dead tissue. Purpose: stop larval food source and bacterial growth. Mechanism: resets the wound to a cleaner bed.

8. Sterile dressing and hygiene: regular cleaning around the eye. Purpose: keep flies away and reduce infection. Mechanism: physical barrier and fewer microbes.

9. Cold compresses (short, gentle): reduce swelling and pain. Mechanism: vasoconstriction and less inflammatory leakage.

10. Rest, head elevation, dim light: comfort measures to lower pain and light sensitivity.

11. Temporary stop of contact lenses: prevents further irritation and infection risk while healing.

12. Protective eyewear outdoors: keeps new flies away during recovery.

13. Vector control at home (nets, screens, clean waste): lowers reinfestation. Mechanism: removes breeding sites and entry routes.

14. Wound care education: how to clean, when to change dressings, and what to watch for. Purpose: empower safe self-care.

15. Tetanus status check (and booster if indicated). Purpose: prevent tetanus from contaminated wounds. Mechanism: immune protection.

16. Nutritional support (adequate protein and vitamins): helps tissue rebuild. Mechanism: supplies amino acids and cofactors for healing.

17. Pain-minimizing habits (no eye rubbing, limit screens): lowers friction on the cornea.

18. Follow-up checks (1–3 days, then as advised): catch any missed larva or new infection early.

19. Amniotic membrane graft (non-drug biologic) if surface won’t heal: Purpose: promote epithelial regrowth. Mechanism: natural growth factors and anti-inflammatory matrix.

20. Psychological support for distress: the idea of “worms in the eye” is frightening; reassurance and clear steps reduce anxiety and improve adherence.

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Drug treatments

Important: Do not self-medicate. Doses below are typical examples; your doctor will tailor them to your situation, location, species involved, and your health profile.

1. Ivermectin (oral) — anti-parasitic.
   Dose: commonly 200 µg/kg once, sometimes repeat after 24–48 h if needed.
   Purpose: kill or paralyze larvae that are hard to extract.
   Mechanism: opens glutamate-gated chloride channels in parasites → paralysis.
   Side effects: dizziness, nausea, rash; rare neurotoxicity; drug interactions possible.

2. Albendazole (oral, off-label for myiasis) — broad anti-helminthic.
   Dose: 400 mg twice daily for 3–5 days (clinician-directed).
   Purpose: adjunct when larvae are multiple or deeper.
   Mechanism: blocks parasite microtubules → impaired nutrient uptake.
   Side effects: abdominal upset, elevated liver enzymes (monitor), headache.

3. Moxifloxacin 0.5% eye drops (topical antibiotic)
   Dose: 1 drop 3–4×/day for 5–7 days.
   Purpose: prevent/treat secondary bacterial infection after removal.
   Mechanism: quinolone inhibition of bacterial DNA gyrase/topoisomerase.
   Side effects: mild burning, bitter taste; rare allergy.

4. Amoxicillin–clavulanate (oral antibiotic)
   Dose: 875/125 mg twice daily for 5–7 days if eyelid cellulitis or wound infection.
   Purpose: treat periocular skin/soft-tissue infection.
   Mechanism: beta-lactam + beta-lactamase inhibitor.
   Side effects: GI upset, diarrhea, allergy; avoid if severe penicillin allergy.

5. Doxycycline (oral antibiotic) — alternative
   Dose: 100 mg twice daily for 5–7 days (or as guided by culture).
   Purpose: covers common skin flora if penicillin-allergic or MRSA risk.
   Mechanism: protein synthesis inhibition (30S ribosome).
   Side effects: photosensitivity, GI upset; avoid in pregnancy/young children.

6. Prednisolone acetate 1% eye drops (topical steroid) — carefully, after removal
   Dose: 1 drop 3–4×/day, short course with taper as advised.
   Purpose: reduce inflammation and scarring once infection is controlled.
   Mechanism: anti-inflammatory gene modulation.
   Side effects: increased eye pressure, delayed healing; avoid if active infection.

7. Cyclopentolate or atropine (cycloplegic drops)
   Dose: 1 drop 2–3×/day short term.
   Purpose: relax ciliary spasm and relieve deep aching pain; protect inflamed iris.
   Mechanism: muscarinic blockade → pupil dilation, ciliary paralysis.
   Side effects: light sensitivity, blurred near vision; systemic effects rare.

8. Ketorolac 0.5% eye drops (topical NSAID)
   Dose: 1 drop 3–4×/day short term.
   Purpose: reduce pain and surface inflammation when steroids are not yet appropriate.
   Mechanism: COX inhibition → less prostaglandin.
   Side effects: stinging; avoid long use in corneal defects.

9. Artificial tears / lubricating ointments
   Dose: drops q2–4h; ointment at bedtime.
   Purpose: comfort, protect the healing surface, reduce friction.
   Mechanism: tear film support and barrier effect.
   Side effects: temporary blur with ointment.

10. Tetanus toxoid booster (vaccine)
    Dose: 0.5 mL IM if >10 years since last dose (or >5 years for dirty wounds), per local guidelines.
    Purpose: prevent tetanus from contaminated tissue.
    Mechanism: triggers protective antibodies.
    Side effects: sore arm, mild fever.

Note: Compounded topical ivermectin eye drops have been reported in case series but are not standard everywhere; they should be used only by specialists with proper compounding oversight.

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Dietary molecular supplements

Ask your clinician before starting supplements, especially if you take other medicines or are pregnant. Suggested amounts are typical ranges for adults.

1. Vitamin A (retinol or beta-carotene) — 700–900 µg RAE/day
   Function: supports corneal and conjunctival healing.
   Mechanism: gene regulation for epithelial growth. (Avoid megadoses—liver toxicity.)

2. Vitamin C — 500–1000 mg/day
   Function: collagen formation for wound repair.
   Mechanism: cofactor for prolyl/lysyl hydroxylase in collagen.

3. Vitamin E — 100–200 IU/day
   Function: antioxidant support during inflammation.
   Mechanism: protects cell membranes from oxidative damage. (High doses may increase bleeding risk.)

4. Zinc — 8–11 mg/day (do not exceed 40 mg/day long term)
   Function: cofactor for DNA synthesis and epithelial repair.
   Mechanism: zinc-dependent enzymes in cell division.

5. Omega-3 fatty acids (EPA/DHA) — 1–2 g/day
   Function: anti-inflammatory support; helps tear film quality.
   Mechanism: pro-resolving lipid mediators (resolvins/protectins).

6. Lutein + Zeaxanthin — 10 mg + 2 mg/day
   Function: macular and retinal antioxidant support.
   Mechanism: carotenoids that filter blue light and quench free radicals.

7. Selenium — 55 µg/day (max 400 µg/day)
   Function: antioxidant enzymes (glutathione peroxidase).
   Mechanism: reduces oxidative stress in healing tissues.

8. Copper — 0.9 mg/day
   Function: cross-linking of collagen and elastin.
   Mechanism: cofactor for lysyl oxidase. (Balance with zinc to avoid deficiency.)

9. B-complex (B2, B6, B12) — usual daily values
   Function: nerve and epithelial metabolism; B2 helps corneal energy pathways.
   Mechanism: coenzymes in ATP production and cell repair.

10. Probiotics (e.g., Lactobacillus rhamnosus) — 1–10 billion CFU/day
    Function: gut support during/after antibiotics to reduce diarrhea.
    Mechanism: microbiome balance; immune modulation.

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Advanced immune/regenerative therapies

There are no approved “stem-cell drugs” for ophthalmomyiasis itself. In severe damage, clinicians may use regenerative or immunomodulating therapies to help the eye recover. These are adjuncts, not replacements for larval removal.

1. Tetanus immunization (TT/Tdap) — as above.
   Function: immune protection after contaminated injuries.
   Mechanism: active immunity against tetanus toxin.

2. Autologous serum tears (20%)
   Dose: typically 1 drop 6–8×/day.
   Function: promote epithelial healing when the cornea won’t heal.
   Mechanism: patient’s own serum provides growth factors (EGF, vitamin A, fibronectin).

3. Platelet-rich plasma (PRP) eye drops
   Dose: as prescribed (often several times daily).
   Function: accelerate surface repair.
   Mechanism: platelet-derived growth factors (PDGF, TGF-β) support cell migration and adhesion.

4. Cenegermin 20 µg/mL (recombinant human nerve growth factor)
   Dose: 1 drop, 6×/day for 8 weeks (for neurotrophic keratitis; specialist use).
   Function: restore corneal nerve health and epithelial integrity.
   Mechanism: NGF receptor activation → nerve regeneration and healing.

5. Topical cyclosporine A 0.05–0.1%
   Dose: 1 drop twice daily.
   Function: reduce surface inflammation and improve tear production in chronic irritation.
   Mechanism: calcineurin inhibition → less T-cell–mediated inflammation.

6. Limbal stem cell transplantation (surgical cell therapy)
   Use: in rare, severe surface destruction with limbal stem cell deficiency.
   Function: rebuilds the corneal surface.
   Mechanism: transplanted stem cells repopulate the limbal niche and restore epithelium. (Done only at specialized centers.)

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Surgeries (what they are and why they’re done)

1. Microsurgical exploration and removal
   What: operating-room removal under a microscope when clinic removal is not enough.
   Why: to reach all larvae, especially those that hide in tight spaces.

2. Eyelid debridement and reconstruction
   What: remove necrotic eyelid tissue; reconstruct with flaps or grafts if needed.
   Why: stop tissue loss, restore lid function and eye protection.

3. Amniotic membrane transplantation (AMT)
   What: place a biologic membrane on the cornea.
   Why: promotes healing of persistent defects and reduces scarring.

4. Pars plana vitrectomy (PPV)
   What: internal eye surgery to remove larvae or debris in the vitreous/retina.
   Why: internal ophthalmomyiasis can scar the retina; PPV removes offenders and stabilizes the eye.

5. Evisceration or enucleation (last resort)
   What: removal of the contents of the eye (evisceration) or the whole eye (enucleation).
   Why: life-saving in uncontrolled orbital myiasis, overwhelming infection, or unsalvageable damage.

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Prevention tips

1. Wear wrap-around eye protection when working with animals or outdoors during fly season.

2. Use hats with visors or head nets in swarms; consider bed nets when sleeping.

3. Apply insect repellents (DEET 20–30% or picaridin 20%) to skin and hat/brim—not directly into eyes.

4. Keep living areas clean, cover trash, and fix screens to limit indoor flies.

5. Cover and clean facial wounds quickly with fresh dressings.

6. Wash hands before touching your eyes; avoid eye rubbing in barns or stables.

7. Take breaks from dusty, windy work, which drives flies toward moist eyes.

8. Care for pets and livestock (deworming, veterinary fly control) to reduce local fly loads.

9. Stay alert when traveling to rural areas in warm seasons; carry eye protection.

10. Seek care early for new eye irritation—early removal is easier and safer.

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When to see a doctor

• Right away if you feel movement, have sudden pain, tearing, light sensitivity, new redness, or blurry vision after fly exposure.

• Urgently if you see a small white worm, have pus, fever, worsening swelling, or a foul smell from the eyelid or socket.

• Immediately if vision drops, you notice a black curtain, double vision, or severe headache—these can signal deeper involvement.

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What to eat and what to avoid

1. Eat enough protein (eggs, fish, legumes, lean meat) to rebuild tissue.

2. Eat vitamin-A–rich foods (carrots, leafy greens, liver in moderate amounts) for surface healing.

3. Eat vitamin C sources (citrus, guava, berries, peppers) for collagen repair.

4. Eat omega-3 foods (fatty fish, flax, chia, walnuts) to calm inflammation.

5. Hydrate well (water, broths) to support tear film and healing.

6. Avoid alcohol while on antibiotics or pain medicines to reduce side effects and dehydration.

7. Avoid smoking and secondhand smoke—they slow healing and irritate eyes.

8. Avoid ultra-processed, very salty, or very spicy foods if they trigger rubbing or worsen dryness.

9. Avoid supplement megadoses (vitamin A, E, zinc) unless your doctor directs them.

10. Avoid unreliable home remedies (kerosene, gasoline, turpentine, or non-ophthalmic oils) anywhere near the eye—dangerous and vision-threatening.

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FAQs

1) Is ophthalmomyiasis contagious?
No. The larvae do not pass person-to-person. The risk comes from new fly exposure, not from the patient.

2) Can it go away on its own?
No. Every larva must be removed. Waiting can cause deeper damage and infection.

3) Is it an emergency?
Yes. It needs same-day assessment and removal by an eye professional.

4) How do doctors remove the larvae safely?
They use a slit-lamp microscope, anesthetic drops, eyelid eversion, gentle sweeping, and fine forceps to extract each larva completely.

5) Will I need medicine after removal?
Often yes: antibiotic drops to prevent infection, sometimes oral antibiotics for eyelid infection, and short steroid drops later to reduce inflammation—only after infection is controlled.

6) When is ivermectin used?
Doctors consider oral ivermectin when larvae are numerous, deep, or hard to extract. It is not a substitute for manual removal.

7) Are home oils or chemicals safe to kill larvae?
No. Do not use household products near the eye. Only ophthalmic-grade ointments may be used by clinicians to coax larvae out.

8) Could I lose vision?
Most external cases heal well if treated quickly. Internal or orbital cases can threaten vision and sometimes require surgery.

9) How soon will I feel better?
Many people feel relief within hours after removal. Surface scratches may take days to weeks to heal fully.

10) Can it spread to the brain?
It is very rare, but orbital infections can spread if neglected. Early treatment prevents this.

11) Will I need imaging?
Only if your doctor suspects deep involvement or if the view is blocked by swelling or bleeding.

12) Can I wear contact lenses during recovery?
Not until your doctor says it’s safe. Lenses can irritate and raise infection risk while the eye heals.

13) What about work and driving?
Avoid dusty, fly-heavy tasks until cleared. Driving depends on comfort and vision—ask your clinician.

14) How can I prevent it from happening again?
Use eye protection, nets/screens, repellents, and good wound care; reduce flies around living and animal areas.

15) Are there long-term effects?
Most people do well. Rarely, scarring or dry eye persists. Follow-up helps catch and treat these early.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 17, 2025.

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