Misdiagnosis bee sting eyelid in 3 cases
0 Introduction Eye bee sting eyelid is a common animal injuries. Based on clear Medical history and clinical diagnosis is not difficult, but in the eyelid or other parts
of the Sting tarsal groove, relatively hidden location of the line if not strictly slit lamp examination accordance with the rules can easily lead to double-check missed or misdiagnosed,
so that the eye injuries are not timely and effective
treatment, and even lead to Medical disputes. our hospital diagnosis and treatment of eyelid 2006/2008 bee sting in 23 cases, including errors, 3 cases of missed diagnosis are analyzed in error, missed diagnosis and preventive measures.
1 Clinical data The group 3 cases, 2 males and 1 female. Aged 16 to 40 years of age, duration of 3d ~ 2wk, 3 patients had history of multiple treatment .3 patients had eyelid swelling, eyelid and conjunctivitis inflammatory reaction, corneal stimulation symptoms of spider web-like corneal
scratches, corneal staining, located in the eyelid and eyelashes side by side within the Sting 2 patients, tarsal groove along the Sting in 1. misdiagnosed as keratitis in 2 cases, 1 case misdiagnosed as conjunctivitis. topical antibiotics and other treatment, but many times difficult to alleviate the symptoms due to treatment. is mainly based on Medical history and a clear corneal irritation, especially the spider web like scratches corneal epithelium, corneal staining, the more to be alert to the presence of Sting. In row slit lamp examination should strictly follow the rules, seriously and carefully from top to bottom, from left to right, from outside to inside, from small times to high power, on the eyelid, lacrimal points, and other parts of tarsal
groove double-check , leaving no. that the surface after Sting with microscopic tweezers out under anesthesia, and given the conventional anti-inflammatory eye drops eye drops .
Section 2d corneal irritation disappeared, the first 3d review
completely cured. typical case: male, 16 years old, due to careless play outside right eye by a bee sting, appeared right eye redness, photophobia, tearing 1wk, outside the hospital was diagnosed as "keratitis" topical anti-infection treatment
without relief. in our hospital with the the same diagnosis and treatment outside the hospital, because no improvement in symptoms and referral. careful eye examination revealed the line: the right eyelid skin and mild swelling, irritation evident, conjunctival hyperemia, corneal epithelial spider web-like scratches, side by side on the eyelid at the lash root can be seen Sting piercing the eyelid, one end of the exposure of about 2mm. in the use of micro tweezers under topical anesthesia out Sting, conventional anti-inflammatory
topical eye drops, eye irritation disappeared the first 2d, the first 3d recovered.
2.1 good site
Bee stings usually occur in the eyelid skin, easy to diagnose, but after a few bee stings in the eyelid or meibomian Sting hidden along the groove, slit lamp examination difficult to find the line to make eye symptoms persist.
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2.2 Clinical features
Although the more hidden parts of the Sting in the diagnosis more difficult, but summed up the following characteristics: (1 bee sting history, (2 eye irritation persists, given the conventional anti-infection treatment is invalid, (3 spider web-like program corneal epithelium injury, corneal staining, (4 Sting fine, lashes only 1 / 3, a pair of difficult to find in the eyelashes.
2.3 misdiagnosis and missed diagnosis and preventive measures
View from the group of patients, eyelid bee stings when a routine slit lamp examination did not carefully check, especially for persistent eye irritation, a history of
repeated treatment, corneal epithelial spider web-like
scratches should be particularly pay attention to the
possibility of bee stings . line slit lamp examination to develop good working habits, there must be steps to a sequence
of careful examination of the eye, leaving, in order to reduce error, the incidence of missed diagnosis .
[References] 1 Peng Guanghua, Li Zhijie, Li Chen. Modern Eye Therapy. Guangzhou: Guangdong Science and Technology Press, 2001:650 Two efficiency rooms and Yang into the offer. Ocular traumatology. Zhengzhou: Henan Medical University Press, 1998:299
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