Ocular inflammation following caterpillar encounter

A girl who presented with a red, watery right eye was found to have caterpillar hairs embedded in her cornea and under her eyelid


Indian clinicians have described their treatment of an 11-year-old girl who presented at hospital complaining of a red, watery right eye.

Writing in BMJ Case Reports, the authors highlighted that on a recent visit to her home village, the girl had accidentally rubbed a caterpillar that was crawling on her face.

On closer examination, the clinicians discovered multiple caterpillar cilia embedded in her cornea with the presence of an epithelial defect, as well as cilia lodged underneath her eyelid.

Her visual acuity was 6/12 in her right eye and 6/6 in her left eye.

Treatment involved removing the cilia with a fine needle and microvitreoretinal forceps under the view of an operating microscope.

Her right eye was treated with topical antibiotics, steroids and lubricants following the procedure.

Image credit: BMJ Case Reports 2019

A week after treatment the patient’s symptoms had resolved and the visual acuity in her right eye was restored to 6/6.

The authors explained that caterpillar cilia can migrate deep into tissue over time and cause inflammation due to the release of toxin thaumetopoein.

“Therefore, careful removal of all the cilia is essential to prevent delayed complications like migration of these cilia in the posterior segment,” they highlighted. 

Image credit: Pexels and BMJ Case Reports 2019