While bees and wasp stingers have similar functions, the two differ in a few notable ways.īee stingers use the barbs to saw into the tissue of the victim, but get caught and anchored into the tissue, making it difficult to remove. ![]() The stinger has barbs which saw through the tissue of the victim being stung. The stinger is held inside the rear end of the abdomen of the bee or wasp prior to stinging a victim. Venom is released through an opening between the stylets. Studies have reported on the biomechanical properties of bee and wasp stingers, which use a pair of stylets (thin piercing part of the bee or wasp) which move back and forth while stinging prey. However, many articles fail to report the type of insect responsible for the “bee sting.” For the purposes of this article, wasp stings and bee stings will be grouped together unless stated otherwise. Some have postulated that wasp stings are worse than bee stings. While wasps and bees are both members of the Hymenoptera order of insects, their venoms differ, thus one would expect their stings to result in distinct presentations. The data published on stings to the eye is limited, mostly consisting of case reports and a few case series, thus there remains a need for further studies. Ocular bee and wasp stings, including stings to the cornea, conjunctiva, sclera, and eyelids, may be devastating to ocular health and visual function. For the purposes of tetanus prevention, bee stings can be considered “clean." However, if a patient is due for a tetanus booster or has never received a tetanus vaccine, it should be given at the time of presentation.Close follow-up is recommended in all cases, as some cases may worsen rapidly over the first several days.For the treatment of ocular bee stings, oral or topical antihistamines are not routinely described in literature, but could be considered in certain cases. Additionally, the authors of this article recommend an Oral Steroid. Consider treating with a Topical Antibiotic, a Topical Steroid, and a Topical Cycloplegic.Ideally the stinger should be removed at a slit lamp, making sure to remove all parts of the stinger. At that point, the barbed stinger may be treated as a foreign body with complete removal if possible. If the stinger has been present for longer, the necessity for removal is heavily debated as the venom has already been fully expressed. If the sting to the eye occurred seconds to minutes prior to presentation, the stinger should be immediately removed to limit venom delivery.For the primary care or emergency department provider, we recommend that the patient has urgent consultation with an Ophthalmologist.Ocular bee and wasp stings have a diverse range of presentations and complications, including: Toxic Keratopathy, Optic Neuritis, Toxic Scleritis, Toxic Endophthalmitis, Glaucoma, and Cataracts.4.2.1 History, Physical Examination, and Symptoms.4.1.1 History, Physical Examination, and Symptoms. ![]()
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