Delayed presentation, deeper peril: Ophthalmia nodosa

Ophthalmia nodosa is an ocular inflammatory reaction due to the lodging of foreign bodies such as caterpillar spines and tarantula hair. Initial manifestations include edematous eyelids, conjunctival injection associated with multiple corneal abrasions. Subsequent migration of insect hair anteriorly to posteriorly may result in nodular conjunctivitis, iridocyclitis, vitritis, and even panophthalmitis. We report a case of ophthalmia nodosa in a military recruit who presented to us 1 week after the injury. By the time, he presented the setae were deep-seated leading to significant ocular manifestations and was initially managed conservatively before actively intervening to remove the setae.