J Korean Ophthalmol Soc.  2016 Dec;57(12):1981-1986. 10.3341/jkos.2016.57.12.1981.

Prognosis of Ocular Injury Caused by Wasp Sting: Case Reports

• Kim HJ
• Shin JH
• Moon SW

• KMID: 2362720
• DOI: http://doi.org/10.3341/jkos.2016.57.12.1981

Abstract

PURPOSE
In the present study, the prognosis of ocular injury caused by a wasp sting was evaluated in two cases: Case 1 was treated by anterior chamber irrigation and Case 2 was simultaneously treated by anterior chamber irrigation and vitrectomy.
CASE SUMMARY
Both patients had unilateral damage and complained of severe eye pain and blurred vision. Severe corneal edema, conjunctival injection, marked anterior chamber inflammatory reaction and the wasp sting through the cornea at the anterior chamber were observed in both cases. In Case 1, anterior chamber irrigation was performed, however, corneal edema was not recovered. Six months after the wasp sting, phthisis was observed. In Case 2, anterior chamber irrigation and vitrectomy were simultaneously performed, corneal edema decreased and epithelial healing occurred. Four months after the wasp sting, the eyeball was stable, but there was no wave on the electroretinogram.
CONCLUSIONS
Unlike the ocular damage resulting from a bee sting, the ocular damage from a wasp sting causes severe toxic reactions and results in poor prognosis. Aggressive treatment including vitrectomy is necessary shortly after wasp sting injury to save both the vision and eyeball.

Keyword

Anterior chamber irrigation; Ocular wasp injury; Vitrectomy; Uveitis

MeSH Terms

Anterior Chamber
Bees
Bites and Stings*
Cornea
Corneal Edema
Eye Pain
Humans
Prognosis*
Uveitis
Vitrectomy
Wasps*

Figure

• 

  Figure 1. Slit-lamp biomicroscopic photograph and vertical ultrasonography scan images of case 1. (A) Mucopurulent keratoconjunctivitis with chemosis and conjunctival injection was detected. (B) Severe anterior chamber reaction and a retained wasp stinger at the 6 o'clock position. (C) Ultrasonography scan image showed no significant abnormality. (D) Cornea edema and anterior chamber collapse with cataract was detected 1 month after injury.

• 

  Figure 2. Slit-lamp biomicroscopic findings of case 2. (A, B) Initial presentation showed severe conjunctival chemosis, conjunctival injection, and total epithelial defect with severe corneal edema. Penentrating site of the wasp sting at 9 o'clock at the mid-periphery of the cornea (arrow). (C, D) Decreased corneal edema, corneal re-epithelization, and improvement of anterior chamber inflammation 1 month after initial visit.

• 

  Figure 3. Vertical ultrasonography scan images of case 2. (A) Ultrasonography scan image showed choroidal edema at initial presentation. (B) Improved choroidal edema 1 month after injury.

• 

  Figure 4. Examination from 4 months after injury in case 2. (A) The electroretinogram was normal on the right eye, but absent on the left eye. (B) Optical coherence tomography image from 4 months after injury demonstrating vitreous haze and atropic retina. Rt. = right; Lt. = left.

Reference

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