Ocular complications of tussock moth cocoon associated injury

Insect-associated intraocular foreign body (IOFB) is a rare etiology of ocular injury. Ocular exposure to tussock moth hairs, or setae, have been associated with ophthalmia nodosa, endophthalmitis, cataracts, and long-term vision loss. We present a case of a vitreous hemorrhage and tractional retinal detachment induced by Tussock moth cocoon setae. A 12-year-old male suffered a left eye injury induced by Tussock moth cocoon setae, causing vitreous hemorrhage and tractional retinal detachment. He underwent pars plana vitrectomy with removal of IOFB, endolaser, fluid-air exchange, and injection of 14% C3F8 gas. He subsequently developed a visually significant cataract treated with lensectomy, intraocular lens implantation, and yttrium-aluminum-garnet laser capsulotomy, after which he regained 20/20 vision. This case demonstrates a rare occurrence of intraocular moth cocoon setae penetration with severe ocular complications. It also demonstrates the challenges of identifying intraocular setae penetration and treatment approach for successful vision rehabilitation despite delayed IOFB recognition.