It has been described as one of the most unusual – and painful – corneal conditions in the field of optometric health, and it is currently affecting residents in the Albury-Wodonga region.
Known as ‘Christmas Eye’, the condition results from a miniscule beetle causing the surface of the cornea to melt.
The condition typically affects people during the holiday season in the hot, dry summer in South Eastern Australia between mid-November and late-February, Optometry Australia reports.
Wangaratta optometrist Mr Robert Holloway from Holloway Vision wrote an article explaining the condition and its management in Pharma in 2019 (page 20). One of the practice’s patients had been affected three times in ten years.
“The level of pain associated with Christmas Eye has achieved folkloric status. The hardy farming types, who make up a sizeable portion of the victims, shake their heads with sympathy when they hear of a friend or colleague who has been affected,” Holloway wrote.
He said the higher the pain level, the more likely the Christmas Eye presentation.
“Patients will often arrive cradling their head with their hand cupped over the affected eye. They are miserable and have often attended following an initial presentation at the local hospital emergency department.”
Holloway also suggested that the timeframe of the pain onset and corneal observation with fluorescein will provide further information to assist with the diagnosis.
More recently, optometrist Ms Kelly Gibbons from Wodonga Eyecare spoke to the ABC following a recent cluster of cases.
“Christmas eye is essentially a really nasty cornea ulcer that happens at the front of the eye caused by a tiny beetle,” she told the ABC.
While a lack of physical evidence has made it difficult to identify the cause, a small hooded beetle from the Orthoperus species is said to be most likely.
As Holloway explained in Pharma, Orthoperus are known to carry the compound Pederin in their haemolymph which is released when the insect is crushed on the skin or eye.
“Pederin is a powerful inhibitor of protein biosynthesis and mitosis and is a known vesicant (blistering agent). With these properties, it is unsurprising that it has such a dramatic effect on the corneal epithelium,” he wrote.
Cases of ‘Christmas Eye’ usually involve the patient doing some sort of outdoor activity like gardening or mowing.
“There’s nearly always a history of them being outside mowing,” Gibbons told the ABC. “That there is something in the grass at that stage that has gotten into someone’s eye. But people don’t always remember something getting into the eye and certainly by the time I see the patient I can’t find anything.”
According to Optometry Australia, symptoms include excessive tears, an unpleasant response to natural light like burning, itching and redness of the eyes, as well as a headache and nausea.
Because of the damage done to the eye, Gibbons said treatment typically involves managing the pain and preventing infections until the surface of the cornea grows back again.
Patients will generally be prescribed anti-inflammatories and a bandage with a silicone hydrogel contact lens, and eye drops.
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