Proactive intervention for nonreactive intraocular migratory caterpillar hair: Safeguarding vision from delayed complications

Ophthalmia nodosa is a rare inflammatory process triggered by caterpillar setae or other specific hairs. We report a case involving an 8-year-old boy who experienced an insect entering his right eye, leading to discomfort, redness, and a foreign body sensation. Multiple caterpillar hairs were removed from the palpebral conjunctiva. In the subsequent days, he exhibited photophobia, and slit-lamp examination revealed corneal epithelial abrasions. After 3 days, two hairs were noted: one in the intracorneal stroma and the other spanning two-third of the corneal stroma, with the remaining one-third extending into the anterior chamber (AC). The following day, the AC hair migrated to the iris, prompting prophylactic removal to prevent the onset of delayed uveitis, and simultaneously, the intrastromal hair was extracted externally. Vision at the first- and third-month follow-ups was 0 LogMar. Prompt hair removal is essential to mitigate potential ocular complications. This case presents a departure from the conventional approach of addressing intraocular hair only upon the emergence of delayed complications and highlights the significance of prompt removal of intraocular hair to prevent potential intraocular damage, along with unnecessary prolonged patient follow-up.