Ono Takashi, Nejima Ryohei, Kinoshita Katsuhito, Mori Yosai, Ohtani Shinichiro, Miyai Takashi, Iwasaki Takuya, Miyata Kazunori
Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan.
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Case Rep Ophthalmol. 2023 Oct 16;14(1):555-561. doi: 10.1159/000533711. eCollection 2023 Jan-Dec.
Toxicity of species to eyes has scarcely been reported. This report presents a case of chemical blepharokeratoconjunctivitis with delayed re-epithelialization caused by in a patient with dry eye after laser-assisted in situ keratomileusis (LASIK). A 47-year-old woman who had undergone LASIK for myopia 10 years prior experienced visual disturbance and pain in her left eye after being hit by a insect in her eye 1 day prior to evaluation. At the initial presentation, dermatitis around the patient's left eye, eyelid oedema, conjunctival chemosis, corneal epithelial defects, and a best corrected visual acuity (BCVA) of 20/200 were noted. No gram-positive/negative bacteria or indication of cellulitis/elevated inflammation was detected. Administration of topical steroids (betamethasone) and antibiotics (topical: cefmenoxime and levofloxacin; intravenous: ceftriaxone) improved the non-infectious chemical blepharokeratoconjunctivitis; however, the large corneal epithelial defect remained for 10 days. Switching from betamethasone to a preservative-free form facilitated re-epithelialization, and the patient's BCVA improved to 20/16 after 2 months. Ophthalmologists should consider the toxicity of the species on the ocular surface and eyelid.
该物种对眼睛的毒性鲜有报道。本报告介绍了一例在准分子原位角膜磨镶术（LASIK）后患有干眼症的患者，因[未提及的物种]导致化学性睑缘角膜结膜炎并伴有延迟性上皮再形成的病例。一名47岁女性，10年前因近视接受了LASIK手术，在评估前1天眼睛被一只[未提及的昆虫]叮咬后，左眼出现视力障碍和疼痛。初诊时，发现患者左眼周围有皮炎、眼睑水肿、结膜水肿、角膜上皮缺损，最佳矫正视力（BCVA）为20/200。未检测到革兰氏阳性/阴性细菌，也没有蜂窝织炎/炎症加剧的迹象。局部使用类固醇（倍他米松）和抗生素（局部：头孢甲肟和左氧氟沙星；静脉注射：头孢曲松）改善了非感染性化学性睑缘角膜结膜炎；然而，较大的角膜上皮缺损持续了10天。从倍他米松改用无防腐剂剂型促进了上皮再形成，2个月后患者的BCVA提高到20/16。眼科医生应考虑该[未提及的物种]对眼表和眼睑的毒性。
