Corneal bee sting with retained stinger – is surgical removal always indicated?

Abstract

Background:

Corneal bee sting is an environmental eye injury which can be blinding meanwhile its management remains controversial.We are sharing two similar cases which were managed differently by surgical and non-surgical methods. 

Method:

Case series with literature review.

Results:

A 45 years old gentleman presented, early post bee sting to his right eye with vision of counting fingers. He had two retained stingers at deep corneal stroma. Treatment initiated with intensive topical steroid, antibiotic and cycloplegia. Symptoms and vision improved hence stinger was not removed. Best corrected vision acuity (BCVA) at 1 month was 6/6 and remained the same at 1 year.

Second case was a 56 years old gentlemen, presented late after similar injury with vison of 6/60 and a paracentral corneal ulcer with retained stinger in mid stroma. The stinger was surgically removed and managed with topical antibiotic and antifungal eye drops. A week post operation, his vision was 6/24 with improving ulcer. At one year the ulcer healed with scaring and achieved  BCVA of 6/12, pinhole 6/9.

Conclusion:

Corneal bee sting injury  management depends on severity of corneal reaction, the distance and depth of the stinger from the visual axis, and its external accessibility. Early  and prompt action is important  to prevent permanent corneal damage while considering surgical removal where necessary. 

Conflicts of Interest :The authors reports no conflicts of interest.