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

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Mar 28, 2024 341 likes •444 views

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

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Pacman Invasion

Omar Punjabi, MD Andrew Antoszyk, MD

Financial disclosures: None

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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

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

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

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And he’s swimming! There’s Waldo

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OCT OD 8/8/2017

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

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From WB Anderson AJO 1935; 8:699-705 Gastrophilus intestinalis=horse botfly

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

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)

Alive Dead