Bee and wasp stings of the eye. Retained intralenticular wasp sting: A case report.

Abstract

SUMMARY Two different stages should be considered in the management of bee and wasp stings to the eye. The first is the acute stage of activity of the specific insect venom on the structures of the eye. The reaction of the eye to the particular insult is considered here in regard to the anterior and posterior segments of the eye. The second stage is that of the retained intraocular foreign body, the inert sting. Little is known about the reaction of the eye to the presence of the chitinous sting and its effect on the structures of the eye. We report a follow-up study of a sting retained for 28 years, and emphasise the benign and quiescent course of the case. Guidelines for treatment and management in such cases are described.

Management of Corneal Infiltration Due to Bee Sting

“…Protein denatürasyonu sonucunda katarakt ve lens subluksasyonu izlenebilmekte ayrıca mellitin iriste depigmentasyon ve heterokromiye yol aça-bilmektedir. 4,5 Bizim olgumuzda herhangi bir katarakt, lens subluksasyonuna, iris atrofisi veya depig mentasyona ait bulgu görülmemiştir. Mellitine bağlı polimorfonükleer lökositlerin kemotaksisi sonucu yoğun korneal ödem etrafında beyaz korneal infiltrat gelişebilir.…”

“…4 Buna bağlı olarak internal oftalmopleji ve sektöryel iridopleji izlenebilmekte, optik nörit ve optik atrofi de görülebilmektedir. 5,7 Olgumuzda bu komplikasyonlara ait bulguya rastlanmamıştır. Mast hücre-sini degranüle edici peptid ise histamin salınımı yapmakta ve damar geçirgenliğini artırmaktadır.…”

Confocal microscopy in bee sting corneal injury

“…[2][3][4] Up to date we are still uncertain of the long-term consequence of retained bee sting in human eyes. 5 Whether it may behave like caterpillar setae, which are well known of their ability to migrate and lead to posterior segment inflammation, is uncertain. 6,7 It is therefore important not to miss any of such foreign bodies, so that appropriate management plan can be made.…”

“…4 However, recently ductal type of lacrimal adenocarcinomas have been reported 1,2 similar to histological subclassification of salivary gland carcinomas. 5 Lacrimal ductal carcinomas have a highly aggressive nature similar to salivary ductal carcinomas. 1 In the first case, the patient underwent modified en bloc orbitectomy with postoperative radiation therapy, and the patient was alive and well without evidence of tumour recurrence 10 months after surgery.…”

Bee sting-induced ciliochoroidal detachment

“…7 Bee and wasp venom contains a mixture of many biologic amines, enzymes, and toxins. Sudden release of highly concentrated biogenic amines, such as histamine in the venom produce vasodilatation and increase in capillary permeability and the immunologic reaction to high molecular weight enzymes in the venom-induced type 1 hypersensitivity response mediated by immunoglobulin E. 2,4,7 Ciliochoroidal detachment or effusion refers to an abnormal accumulation of serous fluid in the outer layer of the ciliary body and choroid, resulting from altered choroidal fluid dynamics. 8 Ocular inflammation increases capillary protein permeability, allowing greater leakage of protein into the extravascular space.…”