IMAGE OF THE MONTH: March 2023
A young female with streaks and haze
35 year old female, woke up yesterday seeing lots of lines, haze, and decreased visual acuity in the left eye. Denies living in a rural area, any recent travel out of the country, consumption of undercooked meat, fish, or poultry, trauma, recent infections, illicit drug use, contact with any farm or wild animals. Patient is well nourished with great hygiene, is otherwise healthy, works from home, and has no significant past medical, surgical, or social history.
DIAGNOSIS
Ophthalmomyasis Interna
Discussion
The patient presented with blurry vision and lines in her vision for <24 hours. Visual acuity in the left eye was 5/200 and examination showed trace cells in the vitreous, retinal hemorrhages, subretinal tracks, and a ~2mm larva was seen moving at a rate of ~0.05mm/second. The differential diagnosis included posterior uveitis, ophthalmomyasis interna, and diffuse unilateral subacute neuroretinitis. The patient was immediately treated with continuous argon laser photocoagulation and topical steroids for inflammation. Visual acuity improved to 20/60 six months after treatment
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