Multiple migratory caterpillar hairs in the eye – A case report

A 40-year-old male presented with a history of caterpillar fall in his right eye with subsequent foreign body feeling, discomfort, and redness to a tertiary care facility in southern India. His best corrected visual acuity in both eyes was 6/6. The IOP in both eyes were within normal range. Multiple caterpillar hairs were seen during a thorough examination of the right eye, in the palpebral conjunctiva, the superficial and deep corneal stroma, and the anterior chamber. There was no anterior chamber reaction. The fundus examination were within normal limits. Under topical anaesthesia, caterpillar hairs in the conjunctiva were removed with the help of forceps. The patient was started on topical steroids and antibiotics. The patient was carefully monitored. The patient's symptoms had improved. During the next visit, caterpillar hairs in the superficial cornea was removed. Despite having hairs in the anterior chamber, this patient had no anterior or posterior chamber reactivity. Two hairs on the iris were visible during the next follow-up, but there were none in the cornea or conjunctiva. The patient is still being followed up on regular basis (9 months). Caterpillar hairs have the capacity to move intraocularly through the cornea and are known to elicit an inflammatory response in the eye. Therefore, it is important to be aware of the potential for intraocular inflammation following the quiescent stage.