Eye Injury from Tarantula

Author: Dr. Terrace L. Waggoner Sr.

This is an old case. I saw the patient 20 plus years ago. I would like to review it, because at the time, I was initially clueless about what the diagnosis was or how to treat it.

Of course, it was a Friday afternoon around 5:00 and we were closing the Optometry Department, Naval Medical Clinic, at Long Beach, CA when a corpsman called and asked if I would see this 22-year sailor with a red eye. The patient had been seen at the local hospital emergency room and the eye was flushed out. No slit-lamp evaluation was performed during the emergency room visit. Also, no definitive diagnosis was made to account for the ocular pain. The patient stated the pain became tolerable after 3 to 4 days, but the eye remained red and irritated. He was assumed by the hospital staff physician to have a viral conjunctivitis and treated with a combination vasoconstrictor-antihistamine.

Physicians routinely referred to optometry red eyes that didn’t resolve or had a tendency to reoccur over time. Most often, I would find an ocular herpetic dendrite or diagnose chlamydia in these cases. I didn’t want to let this patient go undiagnosed over the week-end, so I asked the corpsman to send him over.

On arrival at optometry correctable distance vision acuity was 20/15 in both eyes. Slit-Lamp revealed slight chemosis of the superior and inferior lids of the right eye. The right temporal conjunctiva had 2+ diffuse injection. Concentrated about the temporal region of the cornea of the visual axis were 30 to 40 ocular foreign bodies that looked like clear, acrylic rods. I asked the patient if he had been installing asbestos or working with fiber glass. Like I mentioned, I was clueless about what I was dealing with, until I delved deeper into the case history. The patient had been over to a friend’s house about a month ago. He was holding the friends pet tarantula at arm’s length when he blew a puff of air at the tarantula and it started doing a jigsaw dance with its legs.

When threatened or provoked, the tarantula moves it hind legs to the dorsal part of its abdomen, where urtication barbed hairs are located. It then vibrates it legs rapidly, flicking the barbed hairs into the air and into the path of unsuspecting victims. The barbs of the hairs facilitate deep, merciless penetration into tissue – especially ocular tissue.

I diagnosed the condition as ophthalmia nodosa and it was effectively treated with topical corticosteroids. I wrote the case up and it was published in the Journal of the American Optometric Association 1997 Mar;68(3):188-90. For those interested, download it from here. The article goes into greater detail about the case and how it was treated. Dr. Lloyd Pate also provided a great YouTube Video on the subject as well that can be viewed here