Razmjoo et al our experience in the management of a patient with a corneal bee sting. We aim to describe the patient’s clinical data and outcome and also video-based details of our surgical method in removing the deeply embedded stinger. We will discuss the efficacy of our approach by comparing the features of our case with those of cases previously reported in the literature. Additionally, we suggest a general guideline for the management of corneal bee stings. Case report A 40-year-old Persian male was admitted to our emergency department 20 hours after his right eye was stung by a bee while driving. On arrival, the patient was complaining of severe pain, blurry vision, and tearing, which he had experienced soon after the injury. The right upper and lower eyelids were swollen, and significant conjunctival injection was present. His best-corrected visual acuity was 160/200 in the affected eye. Slit-lamp biomicroscopy revealed a bee stinger embedded into the cornea between an 8 o’clock and a 9 o’clock position. A 5 × 5 mm2 corneal epithelial defect was notable at the site of the sting (Figure 1A–C). The intraocular pressure and depth of the anterior chamber were within normal limits. No anterior chamber reaction was observed. The lens was clear and the iris was normal. Examination was unremarkable in the left eye. Dovepress External removal of the stinger was not possible because the tip of the stinger was not accessible (Figure 1C). The patient was initially treated with a topical antibiotic (cipro- floxacin eye drops every 3 hours), a topical corticosteroid (fluorometholone eye drops every 8 hours), and a topical cycloplegic (tropicamide eye drops every 6 hours). Over the ensuing 2 days, corneal stromal infiltration and edema developed around the stinger site (Figure 1D–F), and visual acuity decreased to 100/200. Thereafter, surgical removal of the stinger was suggested (Figure 2). Under generalized anesthesia, an incision was made perpendicular to the corneal surface over the site of the sting. The (Video 1A)stinger was removed using a needle, (Video 1B) and smears of corneal scrapings were obtained for staining and culture. The cor- neal wound was sutured using a single 10-0 nylon suture (Video 1C). Finally, a subconjunctival injection of cefazolin (50 mg/mL) was given (Video 1D). Postoperatively, the patient received topical ceftazidime and vancomycin eye drops. The tested culture was reported to be negative for bacteria and fungi. Subsequently, topical cip- rofloxacin and tapering doses of betamethasone were replaced. This was maintained for the next 20 days. Of note, the suture was removed 14 days after surgery (Figure 1G and H). Within approximately 30 days of follow-up, the corneal infiltration Figure 1 Photographs of the stung cornea in diffuse/slit illumination during approximately 1 month of follow-up. (A–C) Twenty hours after the injury: the deeply embedded stinger and the corneal epithelial defect are apparent around the site of injury. (D–F) Day 2 of follow-up (ie, the operation date). Note the corneal infiltration and edema, which led us to remove the stinger surgically. (G and H) Fourteen days after the operation: (G) before suture removal; (H) after suture removal. The infiltration is markedly reduced and the corneal epithelial defect is relatively healed. (I) One month after the operation: slight subepithelial scarring remains around the area of the stinger. 1698 submit your manuscript | www.dovepress.com Dovepress Clinical Ophthalmology 2011:5