Tarantula hair keratitis

Abstract

A 39-year-old man who kept pet tarantulas presented to Moorfields Eye Hospital with a red, painful left eye. Examination revealed conjunctival hyperemia, a large inferior corneal keratic precipitate, and anterior chamber cells (A). He was prescribed hourly topical dexamethasone 0.1%. As the keratic precipitate resolved, a hairlike structure was revealed in the posterior corneal stroma (B). Intravital confocal microscopy revealed morphological features of a barbed, urticating tarantula hair, which was too small to be removed surgically (C). The patient required low-dose topical dexamethasone 0.1% for 9 months to control inflammation. He remains asymptomatic at 1 year, with a visual acuity of 20/20 and a quiet eye (D). Ophthalmia nodosa is an ocular inflammatory reaction caused by insect hairs or vegetative material. The tarantula sheds urticating hairs as a defense mechanism. These hairs are capable of penetrating deeply into the eye, causing local inflammatory reactions and, in severe cases, blindness.