Corneal bee sting misdiagnosed as viral keratitis.
OBJECTIVE
To report a case of chronic keratouveitis caused by a missed bee sting injury.


METHODS
A 17-year-old boy was referred for management of unresponsive viral keratouveitis. Ocular examination revealed corneal edema and scarring, atrophic patches on the iris, and anterior polar cataracts. Surprisingly, examination also revealed a retained intracorneal bee stinger. A retrospective inquiry confirmed a bee sting injury 2 years ago.


RESULTS
The patient was started on medical treatment and underwent operative removal of the bee stinger. Postsurgery, visual acuity improved, and the corneal edema regressed over a 1-month follow-up.


CONCLUSIONS
In cases of chronic keratouveitis, a meticulous examination is mandatory to rule out unusual causes like a retained corneal bee stinger. A retained intracorneal bee stinger may result in long-term corneal inflammation, which may not be controlled adequately with topical steroids. It should be removed, irrespective of the duration since the injury.
Jain
Vandana
V
Department of Cornea and External Diseases, Aditya Jyot Eye Hospital, Wadala, Mumbai, India. docvandanajain@rediffmail.com
Shome
Debraj
D
Natarajan
Sundaram
S
D000293:Adolescent; D000818:Animals; D001516:Bees; D065306:Corneal Injuries; D003937:Diagnosis, Differential; D005129:Eye Foreign Bodies / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007634:Keratitis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D014777:Virus Diseases / Q000175:diagnosis* / Q000209:etiology