Christmas Eye (also known as seasonal corneal ulcer, Albury-Wodonga syndrome, harvester's eye, or harvester's keratitis) refers to a seasonal epidemic of corneal ulceration which predominantly occurs in a particular region of Australia, caused by chemicals released upon death by small native beetles in the area.
The condition commonly occurs around Christmas time, hence its name, in the south-west region of the New South Wales and north-east Victoria.
[7] The pain level most commonly ranges to a score of 8 or 9 out of 10, but during the early stages it could be less depending on the degree of corneal disruptions.
[8] When it comes to clinical signs, the eye demonstrates a corneal epithelium disturbance that progresses to an extensive epithelial loss that ranges up to 90% of the cornea.
[9][10][11] Since Pederin is a strong inhibitor of protein biosynthesis and it is a blistering agent, it is not surprising that it causes a major effect on the corneal epithelium.
When the beetle enters the eye and it is crushed, the released chemical, pederin, will cause an autocatalytic reaction which will result in corneal epithelial cell death and ulceration after only a few hours.
In order to diagnosis Christmas Eye, it is essential to take a look at the history, meaning what the patient was doing prior to attending the emergency room or a day before.
Biomicroscopy will show the extent of corneal damage and amount of remaining epithelium present, which will assist in providing a confirmation of the diagnosis.
[8] An essential factor is considering the time of year, since Christmas Eye generally occurs only between late October and early March.
The epithelium in the surrounding area of the infected eye is often disrupted and it demonstrates a considerable amount lost.
Once it is healed, the bandage will be removed and the patient will start using AFT Hylo Forte eye drops daily for two weeks.
This means that in order to prevent the exposure to this toxin, individuals in Australia should be extremely cautious during the summer, specifically if they will be doing outside activities like gardening, mowing, etc.
Patients generally get back to normal once their vision is fully repaired and there are no left-over signs of the corneal ulcer.
[15] Patients often describe being near a body of water the previous evening, and the first cases usually occur when the daytime temperature approaches 30°C - typically late November.
As far as it can be determined, the syndrome has not occurred in large numbers outside the south-west slopes and the plains of New South Wales.
In December of 2019, Robert Holloway (BScOptom) revisited the condition of Christmas Eye in the publication of Optometry Australia.