ACUTE KERATITIS FOLLOWING APOGONIA BEETLE INJURY: A RARE ENCOUNTER

Certain family of beetles are known to release a defensive toxin when threatened, potentially causing ocular surface inflammation and associated symptoms such as periorbital swelling, corneal edema, and keratitis. Involvement of the trabecular meshwork can lead to trabeculitis and elevated intraocular pressure (IOP). We present a rare case of ocular injury caused by an Apogonia beetle in a 65-year-old Malay man with no underlying medical conditions. He was struck in the left eye by a flying Apogonia beetle while riding a motorcycle without a helmet. The beetle clung to his upper eyelid, and after forcibly removing it, the patient experienced immediate burning sensations. He sought medical attention seven days later due to persistent swelling, pain, and progressive visual blurring. On examination, the left eye showed marked conjunctival injection and chemosis, circumcorneal injection, generalized corneal edema and haziness, and a localized epithelial defect nasally. Intraocular pressure was elevated (32 mmHg) compared to the right eye (12 mmHg). Corneal scraping and subsequent Gram stain revealed no organisms, and no bacterial or fungal growth was detected on culture. The patient was treated with topical antibiotics, cycloplegics, topical corticosteroids, and topical Timolol 0.5% BD to address the inflammation, control IOP, and prevent secondary infection. Rapid diagnosis and timely management of keratitis and elevated IOP were crucial for promoting corneal healing, preventing complications, and preserving ocular function.

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