Posters

Hairy tales of caterpillar setae: ophthalmic masquerades

Poster Details

First Author: A.Ghosh Dastidar INDIA

Co Author(s):    D. Khedia   M. Mukherjee   B. Vedapuri Eswaran   S. Bhattacharyya   .         

Abstract Details

Purpose:

Ophthalmia nodosa is a masquerading condition, where the causative caterpillar setae are commonly missed , causing repetitive discomfort to patient and subsequent complication. Caterpillar hair enter the eye by direct contact or indirectly. Their presence in the conjunctival sac commonly causes intense pain ,redness,chemosis , photophobia ,allergic dermatitis and nodular conjunctivitis. Occasionally the hair migrates through cornea and cause severe inflammation after a variable quiescent interval. Intraocular involvements such as iridocyclitis with or without hypopyon, granulomatous iritis, and panophthalmitis We present six cases of different clinical presentations, course, and final outcomes

Setting:

Tertiary eye care in India

Methods:

History regarding exposure to foreign body . Detailed slit lamp examination, along with eversion of lids, rule out seta in conjunctival sac, embedded in cornea and anterior chamber. Ant segment OCT done in one case to remove deep embedded setae in corneal stroma. Ultrasound biomicroscopy done in one case for visualization of deep scleral setae and pars plana region. Fundoscopy done in all cases to rule out intravitrael spread.

Results:

Patients presented with foreign body sensation ,redness ,pain, lacrimation and photophobia . Hairs were found in the conjunctiva (2), cornea (4), and anterior chamber (3).Treatment included topical steroids, cycloplegic, and removal of hairs with forceps (all cases). More than one sitting was required in 3 eyes due to inflammation and obscured visualization of hairs. One eye required AS -OCT for corneal depth estimation and surgical removal. Ultrasound biomicroscopy performed in 2 eyes for visualization of hidden hairs (scleral and pars plana region).Vitrectomy was advised in one case (lost to follow up). Resolution of symptoms occured post removal of all setae.

Conclusions:

Caterpillar setae are notorious and ace in causing masquerades. They have the ability to penetrate the cornea and migrate intra ocular. There is a need for careful and repeated examinations for better visualization of hidden setae post decrease in edema and inflammation under steroid cover and cooperation patient at subsequent examinations. Eversion of lids is mandatory in all cases.Resolution of symptoms occur post removal of causative setae.

Financial Disclosure:

None