[Bee sting of the cornea - a case report].
BACKGROUND
Bee stings of the cornea are very rare, though its response can range from minimal inflammation to severe damage like lens dislocation, cataract formation, iris atrophy, ophthalmoplegia and optic neuropathy. We report on a patient with typical, severe findings.


METHODS
A 42-year-old patient presented with an acute, corneal bee sting of the left eye, after he was stung only a few hours ago. The patient suffered from pain, blurred vision and epiphora. The left eye showed edema of the upper and lower eyelid, conjunctival hyperemia, chemosis, striate keratitis, a purulent infiltration of the cornea above the limbus at the 7 o'clock meridian and a massive hypopyon. Further examinations showed regular ophthalmological findings. Vision acuity was 1,0/0,4. Under therapy inflammation decreased quickly. One week after we could lokalize the stinger in the depth of the corneal infiltration and it was removed surgically. After one month the eye only showed a minimal infiltration of the cornea with fine neovascularisations. Visual acuity was 0,8.


CONCLUSIONS
Clinical reactions to bee stings of the cornea are caused by toxical and immunological effects of different components of the bee venom. These toxical and/or inflammatory reactions can lead to severe intraocular damage. Treatment of choice is the systemic and local application of steroids and antibiotics as well as local therapy with antihistamins.
Grüb
M
M
Universitäts-Augenklinik Tübingen, Abteilung I, Tübingen. matthias.grueb@med.uni-tuebingen.de
Mielke
J
J
Schlote
T
T
D000328:Adult; D001514:Bee Venoms / Q000009:adverse effects*; D003316:Corneal Diseases / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D005123:Eye / Q000473:pathology*; D005131:Eye Injuries / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007299:Insect Bites and Stings / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D014792:Visual Acuity
D001514:Bee Venoms