FEB 28, 2023
AAO 2022 Video Program
Oculoplastics/Orbit, Orbital Diseases
A 55-year-old man from rural northeast India presented with a 1-month history of progressive swelling in the right eye associated with a "crawling" sensation at the site of swelling. He had a prior history of right lower lid basal carcinoma, for which mass excision and lower lid reconstruction was performed 7 years earlier. Local examination revealed an exophytic fungating outgrowth on the right eye with a central cavity, within which live maggots were noted. Orbital noncontrast computed tomography showed intact bony walls and no intracranial extension. Turpentine oil lavage was performed for 3 consecutive days, and maggots were extracted daily. Concurrently, the patient also received oral ivermectin. The patient underwent a right-side orbital exenteration, with intraoperative confirmation of clear margins on frozen section. Temporalis muscle pedicle was rotated into the empty orbital cavity for volume replacement, and the surface was covered with a lamellar skin graft from the thigh. The patient was doing well at 3-month follow-up.
Financial Disclosures: Drs. Kasturi Bhattacharjee, Vatsalya Venkatraman, Obaidur Rehman, and Pragya Bhattacharjee disclose no financial relationships.