Abstract
Corneal sting by wasp is a relatively rare phenomenon. Wasp, bees and yellow jackets belong to Hymenoptera species of insects. A triad of mechanical, toxic and immunologic damage has been proposed to explain the spectrum of injuries from wasp stings. Wasp venom is a complex mixture of toxic substances such as Phospholipase A, Phospholipase B, Apamine, Hyalouronidase, Mast cell degranulating peptide and Mastoparan peptide, which is implicated in direct mast cell degranulation leading to histamine release. A wide range of immunologically mediated ocular sequel have been described which include focal or diffuse corneal edema, bullous keratopathy, panuveitis, hyphema, anterior polar cataract, papillodema, lens subluxation and optic neuritis. The author hereby tends to report a case of Striate Keratitis following wasp sting, its expected pathogenesis, treatment and outcome.
Highlights
A 50-year-old female presented with eye OPD with a wasp sting injury to her right cornea while gardening
Keeping this in mind the patient was started on antibiotic steroid (Predmox 1%) combination 6 times a day to limit the toxic and inflammatory response to wasp venom
A Wasp sting no matter how mild it seems should be investigated meticulously and followed up intensively as late complications are known to occur by virtue of the envenomating nature of poison injected
Summary
A 50-year-old female presented with eye OPD with a wasp sting injury to her right cornea while gardening. She presented within two hours after the bite. The patient complained of severe eye pain along with redness, tearing and mild blurring of vision (Figure 1). The lid swelling was expected to be a consequence of allergic reaction to bee sting. Keeping this in mind the patient was started on antibiotic steroid (Predmox 1%) combination 6 times a day to limit the toxic and inflammatory response to wasp venom. Oral histaminic (Levocetrizine 10 mg) was prescribed for five days at bed time to address allergic lid edema. The antibiotic steroid combination was tapered one drop weekly over a course of 5 weeks while levocetrizine was terminated after five days (Figures 3 and 4)
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