Bristle Worm-Induced Keratouveitis: A Case Report. Issue 5 (May 2020)

• Record Type: Journal Article
• Authors: Kirk, Jonathan; Gunn, David; Wong, Nathan; Minchin, Emily; Darcy, Kieren
• Is Part Of: Cornea. Volume 39:Issue 5(2020)
• Publication Date: 2020-05
• Subjects: bristle worm -- ophthalmia nodosa -- keratouveitis -- seta -- confocal microscopy; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000002225
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To report keratouveitis arising from corneal penetration by a bristle worm seta (bristle). Methods: We report on a 64-year-old woman presenting with uniocular pain, redness, reduced vision, discharge, and pustular rash of the hands after cleaning out her marine aquarium containing bristle worms and rubbing her eye. Results: Slit-lamp biomicroscopy showed pseudomembranous conjunctivitis, corneal punctate erosions, stromal infiltrate, and edema, but no visible foreign body. The anterior chamber developed 3+ cells with hypopyon within 24 hours. Laboratory testing of corneal and hand samples was negative. In vivo confocal microscopy revealed a hair-like seta in the anterior corneal stroma, 25 to 105 μm wide, with surrounding inflammatory cells. Anterior chamber washout was performed. Topical prednisolone 0.5% was commenced, and corneal edema gradually resolved over 3 months. Conclusions: Bristle worms thrive as detritivores in marine aquarium sediment. Aquarium owners risk touching their setae during tank cleaning. Ophthalmia nodosa describes ocular reaction to caterpillar, vegetable, and spider hairs: features include posterior migration of hairs, granulomatous inflammation, and uncertain prognosis. Eye specialists should be alerted to the possibility of bristle worm-induced ophthalmia nodosa. Confocal microscopy may be useful in identifying microscopic setae.