Focal cortical cataract due to caterpillar hair migration

Abstract

Figure 2. Two years after exposure, the caterpillar setae appear to have migrated in the eye. One of them was stuck in the anterior capsule and had produced a small anterior subcapsular opacity.

Ophthalmia nodosa secondary to intraocular, white-marked tussock caterpillar setae (Orgyia leucostigma) in a 15-year-old

“…The setae can subsequently be propelled into intraocular structures, from the anterior chamber into the lens, vitreous humor, and retina. 4 A retrospective analysis published in 2010 by Sengupta et al 8 found that the only significant risk factor for intraocular penetration of caterpillar hair was the presence of deep intracorneal hair at diagnosis, and the removal of intracorneal hairs was only possible in 36% of cases. This illustrates that once setae or hairs have traveled intraocularly, it is exceedingly difficult to remove them and these cases require close interval follow-up to monitor for further serious complications.…”

Ophthalmia nodosa secondary to multiple intraocular caterpillar hairs in a 2-year-old girl

“…[ 4 ] Similarly, only a small number of intra-lenticular setae have been recorded. [ 8 12 ] Agarwal et al . [ 13 ] described a case where a young woman was found to have several caterpillar hairs in areas of her eye, including her AC, sclera, cornea, and pars plana.…”

What’s Eating You? Caterpillars

“…6 In addition, setae can embed in the eye and cause an inflammatory reactionophthalmia nodosa-most commonly caused by caterpillars of the pine processionary moth (Thaumetopoea pityocampa) and characterized by immediate chemosis, which can progress to liquefactive necrosis and hypopyon, later developing into a granulomatous foreignbody response. 2,10 The process is thought to be the result of a combination of the thaumetopoein toxin in the setae and an IgE-mediated response to other proteins. 10 Due to their harpoon shape and forward-only motion, setae might migrate deeper, potentially even to the optic nerve.…”

“…2,10 The process is thought to be the result of a combination of the thaumetopoein toxin in the setae and an IgE-mediated response to other proteins. 10 Due to their harpoon shape and forward-only motion, setae might migrate deeper, potentially even to the optic nerve. 11 Because migration might take years and the barbed shape of setae does not always allow removal, some patients require lifetime monitoring with slit-lamp examination.…”

“…Chronic problems, such as cataracts and persistent posterior uveitis, have been reported. 10,11 Lonomism-One of the most serious (though rarest) reactions to caterpillars is lonomism, a condition caused by the caterpillars of Lonomia achelous and Lonomia obliqua moths. These caterpillars have a unique combination of toxins filling their branched spines, which ultimately leads to the same outcome: a hemorrhagic diathesis.…”