A clinical case that could have had dramatic outcomes, brought about by an unusual bee sting on the eyeball.
A case report was recently published in the New England Journal of Medicine describing an unusual case of a bee sting to a man's eyeball.
Ocular Bee Sting | New England Journal of Medicine (nejm.org)
Every year, about 1 million people go to the emergency room for a bee sting. The bee's sting is equipped with hooks, so after the sting it remains stuck in the wound (and the bee dies) and often the venom apparatus remains attached to the sting and continues to pump venom as long as it remains intact. It is therefore necessary to remove the sting and venom apparatus quickly to stop the flow of toxins.
In the case described, a 55-year-old man from Philadelphia was stung by a bee on his eyeball, resulting in the insect's sting sticking into the iris and passing through the sclera.
The unfortunate man went to an emergency room, probably not a specialist one, where they were unable to extract the stinger.
In the following days the injured person experienced a worsening of the ocular situation with a visual decline and a marked inflammatory reaction.
He went to a specialist eye care facility where the sting was located between the iris and sclera and removed. Treatment with antibiotics and cortisone was prescribed and within about five months there was a resolution of the inflammatory picture with an almost complete recovery of visual function.
It follows that it is advisable to follow the advice of the Istituto Superiore di Sanità to undergo an eye examination as soon as possible in the event of an insect bite to the eyeball and/or periocular area, especially if the injured area shows signs of infection accompanied by systemic symptoms such as fever, satellite lymphadenopathy, muscle and joint pain.
Obviously, such circumstances assume the character of an urgency that cannot be postponed if the general symptoms denote difficulty breathing, swallowing, oedema in the face, mouth and throat, nausea and vomiting, tachycardia, dizziness and lipotimia.
In addition. as a preventive measure to avoid bee stings in an open location, it can be helpful to avoid wearing bright colours, perfumes or hair sprays.
Bees, however, usually attack and sting humans when they feel their hive is in danger and, in any case, as they have a slow mode of flight, it may be wise to walk away if possible.
On the subject of corneal injuries, see also:
- Retinal trauma in children: watch out for the ball - Oculista Italiano
- Eye trauma and fireworks - Oculista Italiano
Dr Danilo Mazzacane - Specialist in Ophthalmology
Shoshany TN, Syed ZA. Ocular Bee Sting. N Engl J Med. 2024 Jun 27;390(24):e64. doi: 10.1056/NEJMicm2400652. Epub 2024 Jun 22. PMID: 38912652.