Ocular Lesions Other Than Stings Following Yellow-Legged Hornet ( Vespa velutina nigrithorax ) Projections, as Reported to French Poison Control Centers

Importance Since the accidental introduction of the yellow-legged hornet (Vespa velutina nigrithorax) in France in 2004, there have been reports of this insect unexpectedly projecting a liquid toward the human face, but ocular morbidity associated with this is unknown, to our knowledge. Objective To describe a case series of ocular lesions after exposure to a liquid projection emitted by a hornet. Design, Setting, and Participants This was an analysis of all cases of ocular exposure to a projection by a yellow-legged hornet (excluding stings in the eye) collected by French poison control centers between January 1, 2004, and December 31, 2019. Main Outcomes and Measures Symptoms were evaluated, and a fluorescein eye stain test was used. Results Twenty-nine cases were recorded (24 in male and 5 in female patients; median age, 40 [interquartile range, 11] years); the first occurred in 2009. Most cases (20 [80%]) were occupational exposure among professionals dealing with hornet nests (eg, firefighters, wasp exterminators). Symptoms consistent with conjunctivitis often resolved quickly after ocular decontamination, but 5 patients developed a periorbital edema, 2 experienced radiating neuropathic pain, and 2 experienced keratitis. Conclusions and Relevance These findings suggest that the projection of a liquid into the eyes by the yellow-legged hornet presents a new risk to human health, but its precise nature remains to be determined. Ocular lesions had a favorable outcome. For professionals who deal with these insects, adaptation of the usual protections designed for native hymenopterans may be warranted.