Clinical Ophthalmology Open Access Full Text Article Management of corneal bee sting Dovepress open access to scientific and medical research C A s e R e P O R T Hassan Razmjoo1,2 Mohammad-Ali Abtahi1,2,4 Peyman Roomizadeh1,3 Zahra Mohammadi1,2 seyed-Hossein Abtahi 1,3,4 1Medical s chool, Isfahan University of Medical sciences (IUM s); 2Ophthalmology Ward, Feiz Hospital, IUMs; 3Isfahan Medical s tudents Research Center (IMsRC), IUM s; 4Isfahan Ophthalmology Research Center (IORC), Feiz Hospital, IUMs, Isfahan, Iran Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: http://dvpr.es/Razmjoo Correspondence: seyed-Hossein Abtahi S.H.A. Official Research Center of Neurological-Ophthalmological sciences (sHARNOs Co), No 9, Boroomand, seyed-Alikhan, Chaharbagh Abbasi, Isfahan 81448-14581, Iran Tel +98 913 409 8036 Fax +98 311 264 3588 email shf.abtahi@yahoo.com Abstract: Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications with an etiology of penetrating, immunologic, and toxic effects of the stinger and its injected venom. In this study we present our experience in the management of a middle- aged male with a right-sided deep corneal bee sting. On arrival, the patient was complaining of severe pain, blurry vision with acuity of 160/200, and tearing, which he had experienced soon after the injury. Firstly, we administered conventional drugs for eye injuries, including topical antibiotic, corticosteroid, and cycloplegic agents. After 2 days, corneal stromal infiltration and edema developed around the site of the sting, and visual acuity decreased to 100/200. These conditions led us to remove the stinger surgically. Within 25 days of follow-up, the corneal infiltration decreased gradually, and visual acuity improved to 180/200. We suggest a two-stage management approach for cases of corneal sting. For the first stage, if the stinger is readily accessible or primary dramatic reactions, including infiltration, especially on the visual axis, exist, manual or surgical removal would be indicated. Otherwise, we recommend conventional treatments for eye injuries. Given this situation, patients should be closely monitored for detection of any worsening. If the condition does not resolve or even deteriorates, for the second stage, surgical removal of the stinger under local or generalized anesthesia is indicated. Keywords: bee sting, stinger, cornea, removal, management, surgery Introduction Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications, including corneal epithelial defect, corneal stromal infiltration, endothelial cell loss, glaucoma, cataract, anterior uveitis, optic neuritis, and even permanent vision loss.1–6 The etiology of these complications is related to penetrating, immunologic, and toxic effects of the stinger and its injected venom through the cornea.1,7 Unfortunately, due to the rarity of this condition, there is no clear guideline for management of affected individuals. Overall, in the current literature, the clinical approach to corneal bee stings remains controversial, ranging from conservative to surgical choices.4,8 On one hand, in some studies, cases were treated only with conventional therapies for eye injury and the stinger remained in situ.3,7 On the other hand, a surgical approach was chosen to remove the retained stingers from the cornea in a number of cases.6,8,9 However, in such instances, the exact surgical procedure is not well described. In the meantime, there is an essential need for a uniform therapeutic algorithm that can summarize the results of sparse studies in the field. In this report we present submit your manuscript | www.dovepress.com Dovepress http://dx.doi.org/10.2147/OPTH.S26919 Clinical Ophthalmology 2011:5 1697–1700 1697 © 2011 Razmjoo et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.