DR. OBAIDUR REHMAN

, Dr.(Mrs.) KASTURI BHATTACHARJEE, Dr. Vatsalya Venkatraman, DR. DIPANKAR DAS

Abstract

A 55-year-old male from a remote rural area presented with gradually progressive swelling in right eye associated with ‘crawling’ sensation. Prior history revealed right lower lid basal carcinoma treated with tumor excision and lower lid reconstruction 7 years ago. Examination revealed an exophytic fungating mass on the right eye with a central cavity, within which live maggots were seen. NCCT orbits showed intact bony walls and no intracranial extension. Turpentine oil lavage with maggot extraction was performed for 3 days alongside oral Ivermectin administration. The patient underwent a right side orbital exenteration, with intraoperative confirmation of clear margins on frozen section. Temporalis muscle pedicle was rotated into the empty orbital cavity for volume replacement and surface was covered with a lamellar skin graft from thigh. Cosmetic rehabilitation was done with spectacle-mounted prosthesis. The patient is doing well at one year follow-up with no local recurrence noted.