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Acta Médica Peruana
versión On-line ISSN 1728-5917
Resumen
ARMAS HERRERA, Gioconda Lourdes; AREVALO AREVALO, Luis Felipe y ARENAS ARCHILA, Eduardo. Insect bite in the cornea, report of a case. Acta méd. Peru [online]. 2023, vol.40, n.1, pp.66-69. Epub 09-Mayo-2023. ISSN 1728-5917. http://dx.doi.org/10.35663/amp.2023.401.2434.
Introduction
: It is very important to consider that the toxin present in wasp venom may lead to a severe reaction damaging visual function. This is the reason why we present the following case.
Clinical Picture
: This is a 32-year-old-female who was bitten by a wasp 24 hours ago in her right eye. She had visual acuity reduction, reddening, tearing, pain, and secretion. Her visual acuity was counting fingers at two-meter distance from her right eye and 20/25 in the left eye. Intraocular pressure was 12 and 13. Biomicroscopy showed conjunctival hiperemia with 3+ periciliary injection. There was a foreign body in the cornea towards the stoma, with 3+ edema. There were striae in the right Descemet. Resultados: We took out the foreign body with previous antimicrobial protection including an antibacterial (tobramycin) and a steroid anti-inflammatory compound (prednisolone). Hypertonic solution and mixed lubricants were also administered, including a mixed lubricant, carboxymethylcellulose, and glycerin. One week afterwards, we observed the formation of an anterior capsular opacity with signs of iris atrophy which led to a ‘change of color in the iris’. Two weeks afterwards we observed periciliary vascular dilatation, at 4-hour meridian; and on the third week, the patient had 20/25 visual acuity in both eyes. Her cornea was transparent, there was persistence of iris atrophy, and there was an anterior capsular cataract. Her symptoms subsided.
Conclusiones
: The exact component of wasp venom leading to the described signs is not known. It has been proposed that it may be a compound with parasympathomimetic action, and this has been related with other clinical observations indicating local depigmentation and heterochromia.
Palabras clave : Insect Bites and Stings; Cornea; Atrophy; Iris; Wasp.