Corneal Mosquito Injury-A Case Report

角膜蚊子叮傷－病例報告

呂威揚(Wei-Yang Lu) ； 沈應誠(Ying-Cheng Shen) ； 蔡顯揚(Hin-Yeung Choi)

《中華民國眼科醫學會雜誌》 49卷1期 (2010/03) Pp. 92-96

https://doi.org/10.30048/ACTASOS.201003.0014

摘要

目的：報告一個角膜被蚊子叮傷的表現及接受治療後的病例。
方法：病例報告。
結果：一名二十歲女性主訴騎車時某種東西飛進左眼，之後左眼產生遽痛及視力模糊。檢查發現部分蟲體嵌入角膜內並有一針狀物刺入前房。經由手術取出蟲體化驗證實為蚊科動物，針狀物為其口針。初期角膜急速水腫混濁並伴局部性浸潤，數天後發現其浸潤往下擴散。給予局部廣效性抗生素及類固醇藥水治療後，角膜除病灶處仍呈局部混濁外，視力逐漸恢復。角膜內皮細胞密度檢查顯示有減少現象。
結論：雖然角膜蚊子叮傷十分罕見但卻會造成非常嚴重之傷害。及時將留存在角膜或前房內的蟲體取出是最重要之治療。合併局部類固醇及抗生素治療將能使傷害減至最低。

並列摘要

Purpose: To report the clinical findings and management of a case of the way in which a mosquito style penetrates into the corneal stroma and anterior chamber.
Method: Observational case report.
Results: A 20-year-old young girl complained severe eye pain and blurred vision resulting from an insect flying into her left eye while riding motorcycle. On examination, visual acuity of the left eye was hand motion. There was a retained insect body incarcerated in the cornea and penetrated into the anterior chamber. It was removed on the day of trauma and identified as the style of a Culicidae (mosquito). The cornea showed diffuse edema and focal stromal infiltrate at the site of injury. Hypopyon and iritis were also noted on the day of trauma. Downward progression of corneal infiltrate along the limbus was noted during the following days. Treatment began with topical antibiotics and atropine for 1 week and topical corticosteroids for 4 weeks. Localized corneal edema persisted during the next 3-month follow-up and specular microscopy revealed low endothelial cell density.
Conclusion: Corneal mosquito bite is a rare injury that displays a variable clinical course which can result in serious damage. A retained intraocular mosquito style should be completely removed as soon as possible. Intensive topical steroids should be applied to decrease the type 1 hypersensitivity reaction and antibiotics administrated to prevent secondary infection. This is key in decreasing the complications of corneal mosquito bites.

並列關鍵字

Mosquito style ； mosquito bite ； corneal perforation ； corneal toxicity