A Tale of Two Patients

In the summer of 2017, as a first-year ophthalmology resident, I encountered a patient, Mr. A, in a rural clinic in north India. He presented with redness, watering, and itching in his eye, which he attributed to a dust particle. However, upon examination, I discovered 10 to 12 worms wriggling on his conjunctiva. After removing the worms, I prescribed topical medications and advised further evaluation if needed. Unfortunately, the sample of worms was lost, preventing further analysis. Five years later, in the summer of 2022, I encountered a similar case in a metropolitan city in south India. Mr. B, who had also experienced itching, redness, and watering in his eye, had worms present as well. This time, I successfully removed the worms and prescribed appropriate medications. Upon further research, I discovered that these worms were first-stage larvae of Oestrus ovis, the sheep nasal botfly. I learned that humans are accidental hosts in such cases and that deeper tissue involvement can occur, leading to necrosis. This experience highlighted the importance of timely diagnosis and removal of these worms. It also emphasized the lifelong learning process for doctors and the need to maintain curiosity.