Johnny is a very healthy and active second grader who could be a poster boy for a Norman Rockwell painting. He has light brown hair that could be mistaken for almost reddish in color, and it is never combed. He has freckles. The front teeth are just now coming in. His voice is raspy due to vocal cord nodules. One can just picture him with a frog in his front pocket, and a slingshot in his back. Johnny is “all boy”.
Mom brought him to the office as a walk-in one afternoon. “I normally would have waited for an appointment, but since it involved Johnny’s eyes I didn’t want to waste any time,” she said as I walked into the room. Johnny was sitting in his chair playing Game Boy. When he looked up he kept the left eye tightly shut. There was a little pool of tears that had welled up in the corner of that eye. He was clearly uncomfortable and unable to let me get a good look at the eye because of the pain. Johnny was a stoic little boy, and it was obvious that he was in a fair amount of discomfort. The quick glance that I was afforded only showed that the white portion of the eyeball was very bloodshot and red. I did not notice pus or discharge.
Mom reported that Johnny was perfectly fine all morning until he went to his friend’s house for a couple of hours. When he came back, she noticed him rubbing the left eye. Within a matter of minutes he was complaining of it hurting. “I figured that this couldn’t be pink eye just because of how fast it came up,” she correctly stated. I asked Johnny if he remembered getting anything in his eye, or even accidentally scratching it, but he did not. “Me and my friend just had lunch at his house and then we played video games,” he recalled. “And then I helped straighten up his room and clean his pet tarantula’s cage.”
I was unable to adequately examine his eye for a foreign body--it was too painful. I was concerned about a sharp foreign body like a shard of glass that might have penetrated the cornea, but he gave no such history. Wanting to waste no time, I called an ophthalmologist friend who told me to send Johnny right over to the office.
I was relieved that he could examine Johnny immediately. He numbed the eye with a topical anesthetic and was able to get a thorough and complete examination. Shortly after he called me with a diagnosis. I was surprised to hear what he found. First was noticed tiny fine hair fibers strewn over the upper lid. When he examined the eye itself, there were tiny barb-like spicules protruding from the cornea, and the eye was inflamed and irritated.
My ophthalmologist friend told me that Johnny had OPTHALMIA NODOSA caused by tarantula hairs. He had been inadvertently sprayed with these hairs at his friend’s house. He explained that opthalmia nodosa refers to any inflammation of the eye and is a type of conjunctivitis. It is the result of insect hairs, stingers or even plant hairs. As I learned that day, tarantulas have an underbelly or abdomen that grossly appears to be soft and velvety. When looked at under the microscope, this represents fine hairs that are sharp and barbed like tiny daggers. As a form of protection, when tarantulas are threatened, they can raise their legs to expose the abdomen and literally shoot “darts” at their enemies.
Johnny admitted that he was mesmerized by the tarantula as it moved around the cage. He said, “It was really cool to watch the animal lift it’s front legs when he got his face close enough.” In reality, the tarantula was frightened by Johnny violating its space. As a protective measure, the spider was firing these microscopic barbs as a defense mechanism. Johnny didn’t even have a clue.
The ophthalmologist was able to remove the barbs from his eye and treated him with a topical steroid and antibiotic. Johnny had a complete and full recovery that I understand was fortunate. The literature suggests that opthalmia nodosa from tarantula hairs has a variable prognosis. Some patients have not been so fortunate.
As mom and Johnny were leaving the eye doctor’s office, Johnny looked at her and asked, “Mom, does this mean that it probably wouldn’t be a very good idea to ask you and dad for a pet tarantula for my birthday?”