Annals of Optometry and Contact Lens 2018;17(2):49-52.
Published online June 25, 2018.
내인성 안내염 환자에서 발생한 안구 후부 파열 및 구후 농양
권지민, 이수정
인제대학교 의과대학 해운대백병원 안과학교실
Spontaneous Globe Rupture and Retrobulbar Abscess Formation in Endogenous Endophthalmitis
Ji Min Kwon, Soo Jung Lee
Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
Received: 10 April 2018   • Revised: 28 April 2018   • Accepted: 30 April 2018
Abstract
Purpose: To report a case of spontaneous globe rupture and retrobulbar abscess formation in endogenous endophthalmitis.
Case summary: A 79-year-old male was referred for visual disturbance and congestion of the left eye for 3 days. He had received total knee replacement in both knees due to degenerative arthritis and cataract surgery in both eyes. The patient was hospitalized due to gram-positive (Streptococcus dysgalactiae) bacteremia, probably originated from septic arthritis in the both knees. Best-corrected visual acuity of the left eye was hand motion. Conjunctival injection and posterior synechiae were observed. Fundus was invisible due to hypopyon and intraocular lens haziness. Endogenous endophthalmitis was suspected, and intravitreal antibiotics injections were performed three times. Ten days after the first visit, exophthalmos and anterior chamber collapse of the left eye occurred, and visual acuity decreased to light perception. Orbital magnetic resonance imaging demonstrated endophthalmitis and retrobulbar abscess of the left eye. Posterior globe rupture was suspected, and enucleation of the left eye was planned. During operation, the pus was flowing out at the perforated posterior globe, and enucleation of the left eye was done.
Conclusions: Prompt recognition of endogenous endophthalmitis is essential to maintain eye globe. Endogenous endophthalmitis should be always suspected in patients who had origin of infectious source or bacteremia.
Key Words: Abscess; Bacteremia; Endophthalmitis; Rupture
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