April 10, 2019 -- The case sounds unbelievable, but it's not: Four tiny sweat bees entered the eye of a Taiwanese woman, fed on their tears and took up residence. The woman had been reportedly visiting a family gravesite when they noticed something in their eye and washed it out, thinking that solved the problem.
However, according to news reports, by evening it had swollen up and they felt pain under the eyelid. The next day they went to the doctor. ln a delicate procedure, their ophthalmologist removed all four of the creatures — still alive — from the woman's tear duct.
Sweat bees, technically called Halictidae, are known for landing on sweaty skin and lapping up salt. They are tiny, often less than a quarter-inch.
WebMD asked two ophthalmologists not involved in the woman's care to shed light on this case — apparently a world first. They are Mark Fromer, MD, an ophthalmologist at Lenox Hill Hospital in New York, and David B. Samimi, MD, an oculoplastic surgeon at Dignity Health California Hospital in Los Angeles, and an assistant professor of ophthalmology at Roski Eye Institute, University of Southern California Keck School of Medicine.
WebMD: How did the bees likely get into the woman’s eyes?
Samimi: Presumably they had entered the tear drainage system through the holes in the eyelid — called the punctum. This is the hole that lets the tears enter the drainage system and ultimately end up in the nose. It sounds odd that they could get in there, but these were tiny bees and the woman may have had a larger than normal punctum.
Fromer: The punctum is [typically] very tiny. It's amazing the bees even got in there.
WebMD: Why did they stay?
Fromer: The corneal surface is a ready source of fluid, salt and glucose for the eye. The bees found a home where the nutritional sources the bees were looking for were readily available.
Samimi: The tear film is essentially a reservoir of salt water, so these bees kind of feed on salt. It stands to reason [they would go for the eyes]. And if you are tearing, it's possible they follow the trail of tears.
WebMD: What would happen if they were not removed?
Samimi: Multiple things could happen. The body usually immediately reacts to foreign bodies, certainly insects. It would probably cause an inflammatory process. It could shut down the tear drainage pathway.
WebMD: How delicate a procedure was the removal?
Samimi: Very delicate. To get them out intact would be one challenge. Another would be dilating the punctum — I presume they had to stretch it out, with a dilator.
WebMD: The woman's eye doctor reportedly praised them for not rubbing their eye. What would that have done?
Samimi: Rubbing may have caused an internal laceration and pushed the insects deeper into the eyelid.
WebMD: What is the likely outlook for the woman's eye?
Fromer: It should be fine, because the bees are gone.
Samimi: I suspect the prognosis should be good if they were all removed. The woman will probably have some inflammation from the fact there were living insects there overnight. But the body is very resilient.
