In Vivo Confocal Microscopy of Pine Processionary Caterpillar Hair-Induced Keratitis

Purpose: Multimodal imaging of processionary caterpillar hair-induced keratitis with anterior segment optical coherence tomography and in vivo confocal microscopy. Methods: Case report. Results: A 25-year-old woman presented with acute keratitis induced by multiple tiny processionary caterpillar hairs. She initially experienced severe pain and moderate vision loss, which gradually improved within a few weeks. Diagnosis was confirmed by in vivo confocal microscopy showing a pathognomonic image strictly comparable with ex vivo microscopy photography. Conclusions: To the best of our knowledge, this is the first case of corneal in vivo confocal imaging of a caterpillar hair with confirmation by ex vivo microscopy.