Pacman Invasion Omar Punjabi, MD Andrew Antoszyk, MD Financial - PowerPoint PPT Presentation

Pacman Invasion Omar Punjabi, MD Andrew Antoszyk, MD Financial disclosures: None

• Patient History • 55-year-old male physician • New onset blurred vision and mild photosensitivity OD • Seeing “lines” in his vision, growing “like a spider web”. • Over a 24-hour period the lines had doubled in number. • Corrected visual acuity 20/40 OD. • Exam was remarkable for a moderate cataract

Fundus Autofluoresence OD 8/8/2017 Color Photo OD 8/8/2017

Late FA OD 8/8/2017 Early FA OD 8/8/2017

There’s Waldo And he’s swimming!

OCT OD 8/8/2017

OCT 10/8/2017 S/P Laser 8/8/2017 VA improved to 20/25 S/P Laser 8/28/2017

• Ophthamomyiasis Interna Posterior • Botfly larvae (rodent, sheep, deer, cattle, reindeer) • Fly strikes the eye, ejects larvae, which burrow through conjunctiva and sclera; may cause conjunctivitis or migrate into subretinal space Alive Dead • Larvae may be • Alive (move)- Chase away from macula and laser or vitrectomy and aspirate in full (in vitreous) • Dead (do not move)- Leave it alone (no inflammation) or vitrectomy and aspirate in full (inflammation) From WB Anderson AJO 1935; 8:699-705 Gastrophilus intestinalis=horse botfly