# Ocular Hornet Injury: A Case Report on Corneal Microperforation and Endophthalmitis

## TL;DR

A 76-year-old farmer developed severe eye damage and infection after a hornet sting, highlighting the need for prompt and specialized treatment.

## Contribution

This case report presents a rare instance of corneal microperforation and endophthalmitis caused by an ocular hornet injury.

## Key findings

- A retained hornet stinger in the cornea led to microperforation and subsequent endophthalmitis.
- Standard antibiotic treatments failed to prevent infection, requiring a scleral patch procedure.
- The case emphasizes the importance of rapid and specialized management to prevent vision loss.

## Abstract

The lesser-banded hornet (Vespa affinis indosinensis) is a prevalent species in tropical and subtropical regions of Asia, including Malaysia. Its stings can result in local reactions, severe anaphylactic shock, and even death. We report a rare case of corneal microperforation and endophthalmitis following an ocular hornet injury. A 76-year-old farmer was attacked by hornets and suffered multiple stings, including one to his right eye. He developed right eye pain, redness, and visual impairment. Ocular examination revealed right corneal haziness with a retained stinger. Attempts to remove the retained stinger were unsuccessful, as the stinger broke and stayed deep in the corneal tissue layer. Corneal microperforation occurred at the site of the retained stinger. Subsequently, he developed endophthalmitis despite extensive topical and systemic antibiotics. He also required a scleral patch procedure for sclerokeratouveitis. This report highlights the importance of quick and vigilant management to prevent severe complications and preserve vision after a hornet sting injury. Retained stingers pose unique challenges that require specialized interventions. There is a need for continuous research and awareness in the management of ocular hornet injuries, aiming to establish standardized treatment guidelines and improve patient outcomes.