Anterior Segment Ophthalmia Nodosa: Two Cases Managed Conservatively

Abstract

Ophthalmia nodosa is a rare inflammatory condition caused by penetration of insect setae into ocular structures, most often from Thaumetopoea pityocampa. Mechanical and immunologic responses contribute to a broad clinical spectrum ranging from conjunctivitis to posterior segment involvement. Diagnosis is often delayed due to the translucent nature of setae.

We report two anterior-segment cases managed conservatively.

Case 1 - A 41-year-old man presented with anterior uveitis after exposure to pine caterpillars. Several intracorneal setae were removed, while deeper ones were left in situ. Topical and systemic corticosteroids led to resolution, with gradual resorption of retained setae.

Case 2 - A 62-year-old woman presented with a large corneal epithelial defect and visual loss after gardening. Combined corticosteroids led to corneal recovery and BCVA 10/10.

These cases highlight distinct presentations of anterior segment ophthalmia nodosa and demonstrate that tailored conservative therapy, when extraction is unsafe, can result in complete resolution and visual recovery.