Corneal honeybee sting.
BACKGROUND
We report the complications and management of a retained bee sting injury to the cornea. The case highlights the acute and chronic management of an uncommon injury and its pathogenesis.


METHODS
A 67-year-old man was attacked by a swarm of bees and was referred for severe chemosis on the right eye. A retained corneal bee stinger (ovipositor) was seen but removal was only partially successful. He subsequently developed a large corneal epithelial defect, anterior uveitis, intractable glaucoma, traumatic cataract, toxic optic neuropathy, and corneal scarring. We reviewed the literature on corneal bee sting injuries and their complications.


RESULTS
Inflammation was controlled with topical steroids and the patient underwent a combined phacoemulsification and trabeculectomy with mitomycin-C for uncontrolled glaucoma. However, optic neuropathy did not resolve.


CONCLUSIONS
Corneal bee sting injuries are uncommon but can result in severe sight-threatening complications such as toxic optic neuropathy. Early recognition of the possible complications and appropriate treatment may help to prevent permanent loss of vision. Removal of a retained corneal bee stinger remains controversial.
Teoh
Stephen C B
SC
The Eye Institute, Tan Tock Seng Hospital, Singapore. Stephen_Teoh@ttsh.com.sg
Lee
Jong-Jian
JJ
Fam
Han-Bor
HB
D000368:Aged; D000818:Animals; D001516:Bees; D003316:Corneal Diseases / Q000209:etiology* / Q000601:surgery; D065306:Corneal Injuries; D005129:Eye Foreign Bodies / Q000209:etiology* / Q000601:surgery; D005901:Glaucoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D009901:Optic Nerve Diseases / Q000209:etiology; D018918:Phacoemulsification; D014130:Trabeculectomy; D014605:Uveitis / Q000209:etiology / Q000601:surgery
D016685:Mitomycin