Successful goniosynechialysis for secondary angle-closure glaucoma after ocular jellyfish sting

Little is known about the ocular effects of jellyfish stings and their optimal management. We report the case of a 25-year-old fisherman that presented to the Emergency Department with a painful red eye, photophobia and blurred vision 24 hours after a jellyfish sting in his right eye (RE), that was projected from a fishing net.

Visual acuity of the RE was 20/80. Examination of the RE revealed anterior uveitis, areas of iris stromal atrophy, 360° peripheral anterior synechiae (PAS) and intraocular pressure (IOP) of 45 mmHg. Left eye was normal. Anterior segment inflammation resolved with topical anti-inflammatory therapy, but IOP remained uncontrolled despite maximal hypotensive therapy. Two months later, goniosynechialysis was performed and restored aqueous outflow, achieving long-term IOP control. The surgery was uneventful, and PAS were separated from the angle using micro-forceps.

This case highlights important ocular findings - acute iris stromal atrophy, extensive PAS and severe ocular hypertension - secondary to jellyfish toxins, raising awareness to the rare entity of jellyfish stings. Early recognition and prompt surgical intervention may be sight-saving, in cases of ocular jellyfish stings, preventing the development of secondary chronic angle-closure glaucoma.