Ocular bee sting with retained stinger

Aims/Purpose: Ocular bee stings are a rare but can lead to severe inflammatory complications. Some cases have been described, but stinger retention is exceptional. We report the case of a young patient with a limbal bee sting, with stinger retention. Methods: A male 19‐year‐old, presented a painful red eye following an accidental bee sting. Examination found a visual acuity of 20/20, conjunctival hyperaemia, a clear cornea, calm anterior chamber, and a perilimbal foreign body, which corresponded to the bee stinger. We performed a conjunctival peritomy and removed the stinger using McPherson forceps under topical anesthesia. The sclera being intact, we sutured the conjunctiva and prescribed antibiotiotics and steroid drops. Evolution was marked with improvement and disappearance of symptoms. Results: Bee sting wounds can penetrate tissues like a harpoon, complicating the stinger's removal, along with possible sequelae: mechanical like corneal abrasion or intrastromal retention, and toxic effects. The venom contains phospholipase A2 and mellitin, leading to membrane lysis and pain, as well as apamin, which causes mast cells degranulation and histamine release. It can cause conjunctivitis, corneal infiltrates, cataract, uveitis, hyphema, lens subluxation, retinal lesions, optic neuropathy or choroidal detachment. Conclusions: Ocular bee stings are rare and can induce severe inflammation. Extraction of the stinger and topical antibiotic associated with steroids are the treatment of choice, in addition to close monitoring of possible complications. References Gudiseva H, Uddaraju M, Pradhan S, Das M, Mascarenhas J, Srinivasan M, Prajna NV. Ocular manifestations of isolated corneal bee sting injury, management strategies, and clinical outcomes. Indian J Ophthalmol. 2018 Feb; 66(2): 262‐268. Chilibeck, C., Wang, N., & Murphy, C. (2021). Making a bee‐line for the eye: a limbal sting and retained honey bee. Clinical and Experimental Optometry , 104 (4), 538–540.