Ophthalmomyiasis Externa in an Atypical Region

Ophthalmomyiasis is a rare condition caused by the infestation of ocular or periocular tissues by fly larvae. It is typically reported in tropical regions, rural settings, or among individuals with animal exposure. This report presents a unique case of ophthalmomyiasis externa in a 2-year-old girl from upstate New York. The patient presented with persistent left lower eyelid edema, erythema, and discharge following an insect bite that was unresponsive to antibiotic therapy. A botfly larva was expressed with digital pressure. The case underscores the diagnostic challenges of ophthalmomyiasis in unlikely regions and raises important questions about the ecological and environmental shifts facilitating the spread of parasitic diseases. Early recognition and intervention, including larval extraction and systemic therapy, proved effective. This report highlights the need for vigilance and broader differential diagnoses in regions where such infestations are uncommon.