Fire Ant Keratopathy In A Pediatric Patient

The occurrence of distinctive punctate corneal lesions has been reported in both humans and animals globally. This condition has been linked to stings by the small red fire ant, Wasmannia auropunctata. We aim to raise awareness of this phenomenon in Israel and its potential for wider recognition globally.

Cornea unit, Department of Ophthalmology, Hillel Yaffe Medical Center, Hadera, Israel

We present a case of a 4-year-old child with fire ant keratopathy and review the available literature.

A 4-year-old boy presented to our emergency room with acute onset of pain, redness, epiphora, and sensitivity to light in his right eye. Examination revealed findings characteristic of fire ant keratopathy, including highly distinctive, fine, punctate, white/grey lesions with overlying fluorescein staining surrounded by distinctive halos. We present slit-lamp and anterior segment OCT images of the corneal pathology.

The patient was treated with topical Ofloxacin 0.3% drops four times a day for three days, with complete resolution of symptoms within 24 hours of presentation. Follow-up examinations at 24 hours and one week later demonstrated resolution of fluorescein staining with persistence of the distinctive corneal findings.

Patients with fire ant keratopathy may not always report a history of fire ant stings. However, the clinical examination reveals highly distinctive corneal features that aid in diagnosis. Focused questioning about potential exposure to fire ants, as in our case, can further support diagnosis. Raising awareness of this potentially emerging cause and its characteristic clinical findings may spare children and their families unnecessary investigations, discomfort, and examinations, followed by potentially years of unnecessary monitoring.