Iritis and angle closure glaucoma caused by caterpillar hairs

Abstract

AbstractPurpose To report on a child presenting with iritis and angle closure glaucoma caused by caterpillar hairs.Methods A 12‐year‐old girl complained of sudden pain and visual loss in her left eye while she was playing in a pinewood. Two hours later, she developed maculo‐papular rash on her limbs. On examination, left visual acuity was 1/10. The affected eye showed conjunctival hyperemia, corneal edema, anterior chamber flare (4+ cells). Corneal staining with fluorescein disclosed diffuse superficial punctate keratopathy. Left IOP was 55 mm Hg. Visante OCT of the affected eye showed a thin, translucent, linear foreign body into the cornea and anterior chamber up to the irido‐corneal angle. Topical steroids, antibiotics, cycloplegics, hypotensive eyedrops, and intravenous mannitol were given.Results Inspection of the place where the girl was playing revealed the presence of numerous processionary pine caterpillars. On the basis of this finding and the clinical data, a diagnosis of iritis and angle closure glaucoma caused by caterpillar hairs was made. After 3 days’ treatment, corneal edema and anterior chamber inflammation resolved, IOP returned to normal, and visual acuity was 10/10 again. However, a small iris cyst was still visible on OCT scans.Conclusion Ocular lesions caused by caterpillar hairs are uncommon. Ophthalmologists should be aware that intense iritis with angle closure glaucoma may be the result of the penetration of caterpillar hairs into the eye. OCT scans may be important to confirm the diagnosis.