A Proposed Protocol for the Acute Management of Palpebro-Orbital Myiasis: Case Report and Review of the Literature.

Periocular and orbital myiasis are rare, vision-threatening conditions characterized by the infestation of dipterous fly larvae into periorbital and orbital tissues. While it has been primarily reported in tropical and subtropical regions where the climate is ideal for fly larval breeding, any patient with inadequate wound care regardless of geography may be predisposed. Infestations can progress rapidly over the course of several days with significant risk of life-threatening intracranial extension. Despite this, there is a paucity of oculoplastic literature describing protocols to treat periocular and orbital myiasis in the acute setting. Here, the authors present a case of periocular and orbital myiasis seen at the Duke University Hospital in Durham, North Carolina (U.S.A.), and describe a protocol that was effective in the eradication of the infestation without surgical tissue debridement.