Ophthalmomyiasis externa – a reporth of three cases

Ophthalmomyiasis caused by Oestrus ovis was first documented in 1974.
While human cases of myiasis are uncommon, they are more frequently observed in
areas with inadequate hygiene and in regions where sheep and goat farming is
widespread. The condition tends to occur more often during the spring and summer
months. The larvae of the sheep fly, Oestrus ovis, are the primary cause of
ophthalmomyiasis, a zoonotic disease. The women Oestrus ovis keeps her eggs inside
her body until they hatch, after which she usually puts her larvae in sheep and goats.
The condition is primarily caused by Oestrus ovis and presents in two forms: external
and internal. Internal ophthalmomyiasis occurs when the larvae penetrate the
eyeball, potentially reaching and damaging the retina. While the external form is self-
limiting, the internal form may lead to severe vision loss. This study presents and
analyzes three cases of external ophthalmomyiasis along with their management
approaches. The skin, eye, nose, paranasal sinuses, throat, intestine, and urogenital
tract are among the anatomical locations where it is known to occur. The most
prevalent kind of ophthalmomyiasis is conjunctival myiasis, which is a benign, self-
limiting condition that is comparatively mild. Roughly 5% of all human myiasis cases
involve an ocular manifestation. Ophthalmomyiasis externa can present with a
variety of clinical signs, including typical conjunctivitis, pseudomembranous
conjunctivitis, blepharoconjunctivitis, punctate keratitis, and keratouveitis. Based on
the symptoms, eye pain is typically preceded by itching (pruritus), conjunctival
redness (hyperemia), a sensation of a foreign body in the eye, and excessive tearing
(lacrimation). These early ophthalmomyiasis externa symptoms could be mistaken
for conjunctivitis. Since the larva can be seen moving in all directions from the side,
detection and diagnosis are made much easier. The foundation of the treatment is
the manual extraction of every larva under local anesthesia, which is followed by eye
washing or rinsing and local therapy. It’s always better to prevent than to cure.
Significant ophthalmomyiasis complications can be avoided with proper personal
hygiene. Three cases of ophthalmomyiasis were identified and treated at the Shtip
Clinical Hospital in the Republic of North Macedonia in 2025. It is typical that all of
the patients are men from rural areas who work in agriculture and animal husbandry.
For farmers and shepherds, myiasis should be regarded as an occupational disease.