Eyeworld

N Contact information Name: by Title DECEMBER 2019 | EYEWORLD | 29 Pars plana vitrectomy was a useful management option for treatment-resistant panuveitis in an unrelated case re- port describing ophthalmia nodosa secondary to tarantula setae penetration in the eye of a young man. The patient suffered from chronic panuveitis despite hair removal and intensive topical steroid therapy for 18 months. The treat- ing physician recommended early pars plana vitrectomy for cases of ophthalmia nodosa for better and faster resolu- tion of symptoms and inflammation. 2 Setae removal at a slit lamp can be difficult due to the hair size and the presence of barbs. Dr. Rao used a 30-gauge needle to rotate the hair within its tract so that the base of the cone was pointed posteriorly, and the tip of the cone pointed anteriorly. This method allowed for better traction for removal when using jeweler forceps, and took advantage of the orientation of the barbs, allowing for smoother unidirectional movement. Four days following setae removal, the patient's left eye was photographed by slit lamp, demonstrating a pinpoint central stromal scar from the central setae removed from that spot. In another unrelated case study involving a young female patient with multiple caterpillar hairs in her cor- nea, sclera, anterior chamber, and pars plana, the treating physician highlighted the importance of regular follow-up visits, because the risk of delayed onset of inflammation is high in patients with ophthalmia nodosa due to the mi- gration of setae. The case study found that early diagnosis and quick removal of setae was vital in preventing the loss of the eye secondary to extensive, recurrent inflammation caused by caterpillar hair toxicity. 3 "The urticating hairs that cause ophthalmia nodosa are 0.3–1.2mm in length, and are sharp, barbed, and capable of penetrating skin, conjunctiva, and the cornea via direct transfer from the surface of fingers after contact, or even through the air," Dr. Bierman explained. "The toxin thau- metopoein is released from the venom glands connected to the hair shaft, causing the inflammatory response. Oph- thalmic manifestations can affect different eye tissues, and may include: allergic conjunctivitis, catarrhal conjunctivitis, and nodular conjunctivitis; localized or diffuse keratitis; and anterior, intermediate, and posterior uveitis; and en- dophthalmitis. Regular follow-up visits were highly recom- mended due to the risk of delayed onset of inflammation from the migration of setae," she said. —foreign bodies that Look to Stephens for titanium instruments. I N S T R U M E N T S | S I N G L E U S E | D R Y E Y E | B I O L O G I C S Stephens Instruments | 2500 Sandersville Rd | Lexington KY 40511 USA Toll Free ( USA ) 800.354.7848 | info@stephensinst.com | stephensinst.com © 2019 Stephens Instruments. All rights reserved. For more than 40 years, Stephens Instruments has served the ophthalmic community. Our line includes a wide seletion of premium titanium instruments all backed by a limited lifetime warranty. You can feel confident in the high quality and superior service from Stephens. Stephens – more than instruments. ST1-1026 Titanium Lieberman Speculum K-Wire ST5-1603 Titanium Utrata Capsulorhexis Forceps ST5-1560 Titanium Castroviejo Suturing Forceps 0.12

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