Corneal bee sting misdiagnosed as viral keratitis

PURPOSE: To report a case of chronic keratouveitis caused by a missed bee sting injury. METHODS: A 17-year-old boy was referred for management of unresponsive viral keratouveitis. Ocular examination revealed corneal edema and scarring, atrophic patches on the iris, and anterior polar cataracts. Surprisingly, examination also revealed a retained intracorneal bee stinger. A retrospective inquiry confirmed a bee sting injury 2 years ago. RESULTS: The patient was started on medical treatment and underwent operative removal of the bee stinger. Postsurgery, visual acuity improved, and the corneal edema regressed over a 1-month follow-up. CONCLUSIONS: In cases of chronic keratouveitis, a meticulous examination is mandatory to rule out unusual causes like a retained corneal bee stinger. A retained intracorneal bee stinger may result in long-term corneal inflammation, which may not be controlled adequately with topical steroids. It should be removed, irrespective of the duration since the injury.