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.
Department of Cornea and External Diseases, Aditya Jyot Eye Hospital, Wadala, Mumbai, India. docvandanajain@rediffmail.com
Vandana
V
Jain
Debraj
D
Shome
Sundaram
S
Natarajan
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