Cornea · 2020
Bristle Worm-Induced Keratouveitis: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Kirk Jonathan, Gunn David, Wong Nathan, Minchin Emily, Darcy Kieren
Аннотация
PURPOSE: To report keratouveitis arising from corneal penetration by a bristle worm seta (bristle).
METHODS: We report on a 64-year-old woman presenting with uniocular pain, redness, reduced vision, discharge, and pustular rash of the hands after cleaning out her marine aquarium containing bristle worms and rubbing her eye.
RESULTS: Slit-lamp biomicroscopy showed pseudomembranous conjunctivitis, corneal punctate erosions, stromal infiltrate, and edema, but no visible foreign body. The anterior chamber developed 3+ cells with hypopyon within 24 hours. Laboratory testing of corneal and hand samples was negative. In vivo confocal microscopy revealed a hair-like seta in the anterior corneal stroma, 25 to 105 μm wide, with surrounding inflammatory cells. Anterior chamber washout was performed. Topical prednisolone 0.5% was commenced, and corneal edema gradually resolved over 3 months.
CONCLUSIONS: Bristle worms thrive as detritivores in marine aquarium sediment. Aquarium owners risk touching their setae during tank cleaning. Ophthalmia nodosa describes ocular reaction to caterpillar, vegetable, and spider hairs: features include posterior migration of hairs, granulomatous inflammation, and uncertain prognosis. Eye specialists should be alerted to the possibility of bristle worm-induced ophthalmia nodosa. Confocal microscopy may be useful in identifying microscopic setae.
METHODS: We report on a 64-year-old woman presenting with uniocular pain, redness, reduced vision, discharge, and pustular rash of the hands after cleaning out her marine aquarium containing bristle worms and rubbing her eye.
RESULTS: Slit-lamp biomicroscopy showed pseudomembranous conjunctivitis, corneal punctate erosions, stromal infiltrate, and edema, but no visible foreign body. The anterior chamber developed 3+ cells with hypopyon within 24 hours. Laboratory testing of corneal and hand samples was negative. In vivo confocal microscopy revealed a hair-like seta in the anterior corneal stroma, 25 to 105 μm wide, with surrounding inflammatory cells. Anterior chamber washout was performed. Topical prednisolone 0.5% was commenced, and corneal edema gradually resolved over 3 months.
CONCLUSIONS: Bristle worms thrive as detritivores in marine aquarium sediment. Aquarium owners risk touching their setae during tank cleaning. Ophthalmia nodosa describes ocular reaction to caterpillar, vegetable, and spider hairs: features include posterior migration of hairs, granulomatous inflammation, and uncertain prognosis. Eye specialists should be alerted to the possibility of bristle worm-induced ophthalmia nodosa. Confocal microscopy may be useful in identifying microscopic setae.