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PHOTO ESSAY
Year : 2022  |  Volume : 60  |  Issue : 4  |  Page : 321-322

Bilateral corneal ulcers and endophthalmitis after eyelid surgery due to multi-drug resistant mixed infections


1 Department of Cornea and Refractive Surgery, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
2 Department of Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India

Correspondence Address:
Radhika Natarajan
Department of Cornea and Refractive Surgery, Sankara Nethralaya, Medical Research Foundation, 18, College Road, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_42_22

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Exogenous infective endophthalmitis is extremely rare after eyelid surgery. A 65-year-old lady presented with bilateral corneal infiltrates and severe anterior chamber exudation after bilateral senile entropion correction. There were multiple fluffy exudates in both the anterior chambers. The left eye was pseudophakic, with yellowish fundal glow. Ultrasonography revealed moderately reflective dot echoes in both eyes. Corneal scraping showed yeast in the right eye. Culture grew Pseudomonas aeruginosa resistant to all drugs except imipenem. Systemic tests for endogenous endophthalmitis were negative. She was started on 5% natamycin and 0.5% imipenem eye drops hourly in both eyes, as well as intravenous imipenem twice a day for five days with supportive treatment. Complete resolution of infection was achieved at one month. The rare bilateral presentation of extra and intraocular infection after entropion surgery, mixed and resistant causative organisms and anterior chamber exudates being disproportionately more than corneal involvement are the unique features of this case.


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