ABSTRACT
PURPOSE: Bee sting injuries to the eye and surrounding tissue are an infrequent occurrence. Here we present an interesting Case of a 64 year old bee keeper who was stung in the left upper eyelid. OBSERVATIONS: After the injury, she developed pain and inflammation of the eyelid though a few days after the injury noted increased eye pain. On initial ophthalmic assessment, no retained foreign body was noted. Six days after the incident, her lid edema had improved and a retained foreign body - the bee stinger - had been found on eversion of the eyelid. We propose that as the inflammation resolved, the stinger extruded from the inner eyelid tissue, causing a corneal abrasion, which was the source of her acute increase in pain. CONCLUSION AND IMPORTANCE: In cases of bee injuries, it is paramount to consider the possibility of retained foreign bodies and to perform a thorough ophthalmic examination and assessment.
Subject(s)
Cataract Extraction , Laser Therapy , Lens Implantation, Intraocular , Phacoemulsification/methods , Female , Humans , MaleSubject(s)
Conjunctival Diseases/etiology , Corneal Diseases/etiology , Dry Eye Syndromes/etiology , Keratomileusis, Laser In Situ/adverse effects , Tears/metabolism , Conjunctival Diseases/diagnosis , Conjunctival Diseases/metabolism , Cornea/innervation , Cornea/pathology , Cornea/surgery , Corneal Diseases/diagnosis , Corneal Diseases/metabolism , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/metabolism , Humans , Hypesthesia/diagnosis , Hypesthesia/etiology , Myopia/surgery , Risk FactorsABSTRACT
PURPOSE: To examine the safety and efficacy of anterior ciliary sclerotomy to restore accommodation in the presbyopic eye. DESIGN: Prospective nonrandomized comparative single-center clinical trial. PARTICIPANTS: Nine presbyopic subjects with no prior ocular surgery except corneal refractive procedures were enrolled. METHODS: One eye from each subject was chosen, in consultation with the patient, to undergo anterior ciliary sclerotomy. The contralateral eye of each subject served as a control. Examinations were performed preoperatively, and at 1 day, 1 week, 1 month, and 6 months after surgery. MAIN OUTCOME MEASURES: (1) Accommodative amplitude, measured by two methods, (2) Jaeger reading vision at 14 inches wearing best distance correction, (3) manifest refraction, (4) assessment of operative complications. RESULTS: For the nine study eyes, there was no statistically significant change between the average accommodative amplitude at the preoperative visit (1.11 diopter [D]) and the 1-month postoperative visit (1.19 D, P = 0.55) nor at the 6-month postoperative visit (1.31 D, P = 0.21) in the study eyes. There was no significant difference between the study and control eyes' change in accommodative amplitude at 6 months (P = 0.43). Logarithm of the minimum angle of resolution equivalent of Jaeger reading vision in the study eyes at 14 inches wearing best distance correction showed no statistically significant change from the preoperative visit (0.53 [20/70]) at the 1-month postoperative visit (0.41 [20/50], P = 0.07) or at the 6-month postoperative visit (0.48 [20/60], P = 0.22). There was no significant change in manifest refraction spherical equivalent in the study eyes at 1 and 6 months postoperatively. One eye experienced a perforation of the anterior chamber during surgery. A second eye experienced mild postoperative anterior segment ischemia manifested by sectoral iris akinesis. CONCLUSIONS: Anterior ciliary sclerotomy does not restore accommodation in presbyopic eyes and can cause significant complications.
