Bee sting to the cornea: toxic effects and management

A 62-year-old man with a history of bee allergy presented with severe eye pain one day after being stung in the eye by a bee. Figure A shows corneal oedema due to endothelial toxicity secondary to bee venom. Despite ideal management of intensive topical steroids and antibiotic drops, the cornea did not recover. An endothelial keratoplasty, rather than penetrating keratoplasty, was performed 6 months later. Two weeks after the transplant, his cornea started to clear (Figure, B), and vision improved from 1/60 to 6/18. The entry site of the stinger can be seen as an area of white scarring within the cornea stroma.