Bee sting keratopathy with retained stinger

• Published in: Journal of coastal life medicine Vol. 4; no. 1; pp. 83 - 84
• Main Authors: Wah, Lott Pooi, Ahmad, Syed Shoeb, Voon, Yew Yih, Ghani, Shuaibah Abdul, Subrayan, Visvaraja A/L
• Format: Journal Article
• Language: English
• Published: phthalmology Department, University of Malaya, Jalan University, 50603, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, Malaysia%0phthalmology Department, Queen Elizabeth Hospital, Karung Berkunci No.2029, Jalan Penampang, Kota Kinabalu, 88560, Kota Kinabalu, Sabah, Malaysia 01.01.2016
• Subjects: Bullous keratopathy; Stinger; Striate keratitis; Venom; Corneal wasp sting keratopathy
• ISSN: 2309-5288; 2309-6152
• DOI: 10.12980/jclm.4.2016j5-115

This case report aims to report an uncommon case of bee sting keratopathy with retained stinger. A 55-year-old man presented with left cornea bee sting while gardening two days prior to first visit. He complained of severe eye pain with redness, tearing and blurring of vision. On examination, his right eye visual acuity was 6/6 and in left eye was hand movement. There was generalized conjunctival hyperemia and cornea showing significant descemet striae. A bee stinger with surrounding infiltration noted at 2 o'clock was associated with striate keratitis. It was deeply seated at the posterior third of cornea stroma near to paracentral area. Pupil was mid-dilated with absence of relative afferent pupillary defect. There was neither hypopyon nor cataract. The posterior segment could not be visualized due to severe corneal edema. However, B-scan ultrasound was normal. Bee stinger was removed under local anaesthesia on the day of presentation. Post-operatively, patient was administered with topical moxifloxacin and topical non steroidal anti-inflammatory drugs. Three weeks later, there was resolution of cornea infiltrate with improvement of striate keratitis and his vision was improved to 1/60. However, cornea edema did not regress but ended up with bullous keratopathy. The patient has undergone descemet-stripping automated endothelial keratoplasty and his vision was improved to 6/9. We recommend early stinger removal to reduce the possible sequelae of bee sting toxicity for better visual outcome.