Hymenoptera insect stings: Ocular manifestations and management

Abstract

Purpose: To describe the ocular findings and management of Hymenoptera insect stings.

Methods: We treated and followed 8 patients with ocular Hymenoptera stings. All patients were admitted through emergencies and hospitalized at the Hedi Rays eye institute in Tunis.

Results: The site of the sting was the cornea in 5 cases, limbus in one case, conjunctiva in one case and upper lid in the last case. Retained stingers were objectified in 4 cases. Immediate surgical extraction carried out in all cases. We also followed one case of post-sting Adie's syndrome and one case of retrobulbar optic neuritis. The sting was conjunctival in one case and palpebral in the other case. Corticosteroids were ineffective in these two cases.

Conclusion: Ocular Hymenoptera stings are rare environmental accidents. They may cause various severe ocular complications. Early management, adapted to the clinical manifestations, is the key to a good outcome.

Keywords: Adie's syndrome; Corneal infiltrate; Hymenoptera insect sting; Infiltrats cornéens; Névrite optique rétrobulbaire; Piqûre d’hyménoptères; Retrobulbar optic neuritis; Syndrome d’Adie.