Published on May 26, 2021

closeup of bug bite near mans eye

Bugs, Their Bites and Your Eyes

Summer is here again, and with it comes good things, and bad.

Among the worst? Those biting, stinging bugs. They're mostly more annoying than anything, but a sting or a bite on your face – near your eyes – can be much more than just frustrating.

“Bug bites can cause pain, redness and swelling, and if that happens close to your eye, it can be an issue that needs care,” said Avera Marshall Southwest Ophthalmology optometrist Michael W. Ohlson, FAAO, OD. “Most often the swelling is associated with an allergic reaction for which the usual initial treatment is cold compresses, oral antihistamines or topical steroids. However, if the site of the bug bite becomes infected it can cause a more serious problem, preseptal or orbital cellulitis.”

Ohlson said orbital cellulitis can be life-threatening, and is often accompanied by significant eyelid swelling, redness, blurred vision, fever, pain especially during eye movement, headache and double vision. Preseptal cellulitis, while not as serious, can lead to orbital cellulitis, so both require intervention with antibiotics in a timely fashion.

“If you develop any of these symptoms after suffering a bug bite close to your eye, see your eye doctor ASAP,” he said. “Some bugs carry diseases that can affect you and your eyes in more serious ways, and that includes diseases like Lyme disease, Chagas disease, dengue and yellow fevers and West Nile virus.”

Common Midwestern Conditions

Lyme disease and West Nile are the most common of these conditions in the Midwest. A bacterium carried and spread by deer ticks is what leads to Lyme disease, and early symptoms include fever, rash, facial paralysis and arthritis. If left untreated or if treatment is delayed, symptoms will worsen, and central nervous system problems can develop.

“Eye problems can come with Lyme disease, and include cranial nerve problems that may cause double vision, abnormalities in your pupils and optic nerve problems,” Ohlson said. “Painful optic neuritis, inflammation of many individual parts of the eye as well as light sensitivity all could be part of Lyme disease.”

A clinical blood test is needed to determine if you have Lyme disease. Unfortunately, false negative results are commonplace, and many people go months or years with symptoms.

“Initial treatment consists of using an appropriate antibiotic, while more advanced treatment depends on the manifestation of the disease,” said Ohlson. West Nile virus is another somewhat common Midwestern disease. Most infected people have few or no symptoms, but those who do show signs suffer from fever, headache, vomiting or rashes.

“Mosquitoes spread West Nile, and it can lead to more serious neurological symptoms as well as eye problems including fear of light or photophobia, eye pain, decreased vision, floaters and swelling,” he said. “If you are diagnosed with West Nile or any of the other illness from bugs, get your eyes examined as soon as possible to help avoid discomfort or ocular damage.”

Some Stings are Emergencies

Finally, bee, wasp or hornet stings near the eye can be an emergency.

“The stinger of an insect can cause more problems if left alone because they are sharp and barbed and they can continue to do damage if not removed,” Ohlson said. “The stinger’s poisons can also cause damage to the structures of the eye, and so too can your body’s immune response to the foreign object.”

Seek urgent or emergency care, preferably with an optometrist or ophthalmologist – before the eye starts swelling – to get that stinger out.

“Get some ice on the eye and take an oral antihistamine while you make your way to the eye doctor. It could really help because when tissues are swollen, it’s harder to remove that stinger,” he said.

And if what’s bugging you is a bug in your eye, it’s an irritation that’s easily fixed.

“If you get a gnat or other bug in your eye, just flush the eye with sterile saline solution,” Ohlson said.

Learn more about eye care professionals who can help you all summer long.

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