A Case Series of Bee Sting Keratopathy With Different Outcomes in Malaysia

Abstract

We report three patients with corneal bee sting at our tertiary care center in a three-year period starting from 2014 to 2016. All patients sustained a bee sting injury to the cornea. All patients received early preoperative topical antibiotics, topical cycloplegic and intensive topical steroids. However, the timing of the initial presentation, the duration, and the location of the retained stinger differed in each case leading to different postsurgical outcomes.

Making a bee-line for the eye: a limbal sting and retained honey bee

“…Treatment regimens described in the literature include various combinations of topical and oral antihistamines, steroids, and broad-spectrum antibiotics. [2][3][4][5][6] Reported visual outcomes vary based on the site of the sting, insect species, endothelial recovery, corneal scarring, cataract development, and patient allergy status to bee and wasp venom. [2][3][4][5]7 Keratoplasty has often been utilised.…”

“…[2][3][4][5][6] Reported visual outcomes vary based on the site of the sting, insect species, endothelial recovery, corneal scarring, cataract development, and patient allergy status to bee and wasp venom. [2][3][4][5]7 Keratoplasty has often been utilised. [3][4][5] In some cases, the stingers were left in situ without further complication.…”

“…[2][3][4][5]7 Keratoplasty has often been utilised. [3][4][5] In some cases, the stingers were left in situ without further complication. 2,7…”

A Case of Conjunctival Bee Sting Injury with Review of the Literature on Ocular Bee Stings

“…The surgical removal of the stinger may be complicated and can result in additional corneal scarring after removal [30]. These complications can cause reduced visual acuity by altering the transparency of the cornea, depending on the initial location of the stinger, which may be either central or paracentral [27]. Retention of the bee stinger combined with appropriate treatment has been described by some authors where the distal portion of the stinger is left in place, especially when local complications or inflammation were present [21,24,25,31].…”

Corneal bee sting: improvement in the acute stage in the absence of treatment

“…Patients with a bee sting injury to the cornea usually present with pain and decreased vision associated with clinical findings of conjunctival injection, corneal infiltration, corneal edema, and anterior chamber inflammation [ 1 - 4 ]. The outcomes of corneal bee sting injuries are highly variable, with outcomes ranging from mild loss of vision to more serious sequelae requiring surgical intervention, such as corneal decompensation or scarring, cataract formation, and glaucoma [ 2 ].…”