Caterpillar Setae-Induced Ocular Complications: A Case Report

This report presents the 2-year follow-up of a rare case of ocular injury caused by caterpillar hairs (setae), highlighting the clinical course, complications, and management strategy, including surgical intervention.

A 39-year-old male presented 6 months after exposure to a caterpillar cocoon with decreased vision, photophobia, floaters, temporal photopsia, and conjunctival injection. Examination revealed multiple setae embedded in the cornea, conjunctiva, and retina, with associated vitreous inflammation and retinal scarring. The patient underwent pars plana vitrectomy, removal of intraocular setae, and endolaser photocoagulation around retinal entry sites.

The patient's vision gradually improved following surgery, stabilizing at 20/20 visual acuity at 2-year follow-up.

This case highlights a quite rare occurrence of intraretinal caterpillar setae and their potential for severe ocular complications. Prompt recognition, detailed examination, timely surgical intervention, and consistent long-term follow-up are critical to preserving vision. Scleral penetration as a potential mechanism for intraocular setae in similar cases should be considered, emphasizing the importance of maintaining a high index of suspicion and intervening at an appropriate time to minimize the risk of deeper tissue involvement and long-term visual sequelae.