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Open Access Case report

Synthetic fiber from a teddy bear causing keratitis and conjunctival granuloma: case report

Mohammed K Farooq1, Jan U Prause2 and Steffen Heegaard12*

Author Affiliations

1 Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark

2 Eye Pathology Section, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark

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BMC Ophthalmology 2011, 11:17  doi:10.1186/1471-2415-11-17

Published: 20 June 2011

Abstract

Background

To report a case of keratitis and a case of conjunctivitis caused by synthetic fibers from toy teddy bears.

Case presentation

Case stories with histopathological analysis. 1) A two-year-old girl developed a severe case of keratitis and corneal ulceration. The initial treatment with various antibiotics gave no improvement and eventually the patient developed spontaneous perforation of the cornea. The corneal swabs contained no bacteria or fungi. Corneal grafting was performed and the corneal button was sent for histopathological examination. 2) A five-year-old girl presented with ocular irritation in her left eye. Examination revealed a conjunctival granuloma in the inferior fornix. The lesion was excised and histopathologically examined.

Results

Microscopy revealed synthetic fibers embedded in the cornea and in the conjunctival granuloma. The diagnosis was confirmed by demonstration of marked birefringence of the synthetic fibers. Microscopical examination of synthetic fibers from two different types of fur (whiskers and face hairs) from the two-year-old girl's teddy bear was performed. Hairs from the face of the teddy bear were morphologically and microscopically identical with the fibers causing the severe corneal ulceration in the two-year-old girl.

Conclusions

Doctors should especially in small children be aware of the risk of ocular consequences of close exposure of synthetic fibers from stuffed toy animals. Corneal ulceration, clinically presenting as corneal infection with negative culturing and staining, should lead to a different clinical strategy and treatment. The treatment of conjunctival synthetic fiber granuloma is excision and antibiotic eye drops.