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Bristle Worm-Induced Keratouveitis: A Case Report.

Jonathan Kirk1, David Gunn1, Nathan Wong1

  • 1Bristol Eye Hospital, Bristol, United Kingdom; and.

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A marine aquarium owner developed severe eye inflammation after a bristle worm seta penetrated her cornea. This case highlights the risk of ophthalmia nodosa from bristle worm setae, requiring prompt diagnosis and treatment.

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Area of Science:

  • Ophthalmology
  • Marine Biology
  • Toxicology

Background:

  • Bristle worms are common detritivores in marine aquariums.
  • Aquarium hobbyists risk exposure to bristle worm setae during tank maintenance.
  • Ocular injury from foreign bodies can lead to severe inflammation and vision loss.

Observation:

  • A 64-year-old woman presented with unilateral eye pain, redness, and decreased vision after cleaning her marine aquarium.
  • Clinical examination revealed pseudomembranous conjunctivitis and corneal abnormalities, with no visible foreign body.
  • Anterior chamber inflammation, including hypopyon, developed rapidly.

Findings:

  • In vivo confocal microscopy identified a microscopic bristle worm seta within the corneal stroma.
  • Laboratory tests on corneal and hand samples were negative for infection.
  • Treatment with topical corticosteroids and anterior chamber washout led to gradual resolution of corneal edema over three months.

Implications:

  • Bristle worm setae can cause a form of ophthalmia nodosa, an inflammatory reaction to foreign animal hairs.
  • Ophthalmologists should consider bristle worm setae as a potential cause of severe keratitis and uveitis in aquarium owners.
  • Confocal microscopy is a valuable tool for diagnosing microscopic foreign bodies in the cornea.