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Case Reports
. 2018 Feb 22:8:Doc02.
doi: 10.3205/oc000084. eCollection 2018.

Intraocular inflammation in a case of bee sting injury

Ekta Rishi  1 , Pukhraj Rishi  1
Affiliations
Case Reports

Intraocular inflammation in a case of bee sting injury

Ekta Rishi et al. GMS Ophthalmol Cases. .

Abstract

A19-year-old man presented with decreased vision in the right eye following a bee sting injury, ten days back. Examination revealed conjunctival hyperemia at the site of the sting, anterior uveitis, vitritis, mild disc hyperemia, ocular hypotony, and striae at macula. Treatment was initiated elsewhere with topical antibiotics, steroid, and cycloplegic. Systemic steroids were added. Three weeks later, vitiritis resolved, intraocular pressure became normal and the vision improved from 20/60 to 20/20. However, a chorioretinal atrophy in the vicinity of the sting site was noted. Global electroretinogram (ERG) revealed reduced scotopic responses and depressed oscillatory potentials; even though the photopic response was normal. Multifocal ERG and microperimetry were normal. Two months later, after discontinuation of medication, a traumatic mydriasis with a sluggish pupillary reaction was noted. Sixteen months later, the fundus remained stable. This is a rare case report of a bee sting injury leading to anterior uveitis, vitritis, and cilio-choroidal detachment, mimicking endophthalmitis. Timely recognition of the cause of the intraocular inflammation and appropriate treatment led to optimal recovery.

Keywords: bee sting; choroidal detachment; pupil; uveitis; vitritis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. At presentation. External photograph of the right eye reveals conjunctival congestion in the inferonal quadrant of the eye with a prominent area of scleral protuberance (arrow) signifying the site of the bee sting injury.
Figure 2
Figure 2. Color fundus photograph of the eye at presentation. Internal limiting membrane (ILM) folds over the macula and mild disc hyperemia are noteworthy.
Figure 3
Figure 3. Three weeks after presentation. Color fundus montage of the right eye reveals minimal media haze overlying the affected quadrant with an area of chorioretinal pigmentation.
Figure 4
Figure 4. Global ERG reveals reduced scotopic responses and depressed oscillatory potential in the right eye. Photopic response was normal.
Figure 5
Figure 5. Multifocal ERG (trace array) reveals preserved macular function in the right eye.
Figure 6
Figure 6. Macular perimetry reveals normal retinal sensitivity values with absence of scotoma.
See this image and copyright information in PMC

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