Ophthalmia Nodosa

A patient presented to the Bascom Palmer Eye Institute retina/uveitis clinic with 2 months of right eye irritation and floaters. He reported being hit in the right eye by a large flying insect while working on a cruise ship in the Bahamas immediately prior to the onset of symptoms. He saw a local ophthalmologist who prescribed topical prednisolone drops for 14 days. Patient completed this one week prior to presentation with persistent symptoms. He was found to have multifocal punctate corneal infiltrates, anterior chamber flare, anterior capsule pigment, peripheral vitreous opacities, and a focal maculopathy. A presumed moth hair was identified in the anterior hyaloid face. The patient was diagnosed with a Type V ophthalmia nodosa due to intraocular penetration and vitreous involvement. His intermediate uveitis improved following two weeks of high dose oral prednisone. However, treatment was discontinued due to severe drug-induced hyperglycemia. Exam remained stable one week later and the patient returned to the Bahamas, with a plan to return for further management and possible surgery if symptoms recur.

Presentation Date: 11/04/2021

Issue Date: 11/12/2021