Blepharokeratoconjunctivitis Presumably Caused by Paederus fuscipes, a Beetle: A Case Report.

Abstract

Toxicity of Paederus species to eyes has scarcely been reported. This report presents a case of chemical blepharokeratoconjunctivitis with delayed re-epithelialization caused by Paederus fuscipes in a patient with dry eye after laser-assisted in situ keratomileusis (LASIK). A 47-year-old woman who had undergone LASIK for myopia 10 years prior experienced visual disturbance and pain in her left eye after being hit by a P. fuscipes insect in her eye 1 day prior to evaluation. At the initial presentation, dermatitis around the patient's left eye, eyelid oedema, conjunctival chemosis, corneal epithelial defects, and a best corrected visual acuity (BCVA) of 20/200 were noted. No gram-positive/negative bacteria or indication of cellulitis/elevated inflammation was detected. Administration of topical steroids (betamethasone) and antibiotics (topical: cefmenoxime and levofloxacin; intravenous: ceftriaxone) improved the non-infectious chemical blepharokeratoconjunctivitis; however, the large corneal epithelial defect remained for 10 days. Switching from betamethasone to a preservative-free form facilitated re-epithelialization, and the patient's BCVA improved to 20/16 after 2 months. Ophthalmologists should consider the toxicity of the Paederus species on the ocular surface and eyelid.

• Authors: Takashi Ono, Ryohei Nejima, Katsuhito Kinoshita, Yosai Mori, Shinichiro Ohtani, Takashi Miyai, Takuya Iwasaki, Kazunori Miyata
• Journal: Case reports in ophthalmology (Case Rep Ophthalmol) 2023 Jan-Dec Vol. 14 Issue 1 Pg. 555-561 ISSN: 1663-2699 [Print] Switzerland
• PMID: 37901643 (Publication Type: Case Reports)
• Copyright: © 2023 The Author(s). Published by S. Karger AG, Basel.