Posters

Successful treatment with good visual outcome in a case of bilateral endophthalmitis complicated peripheral ulcerative keratitis post cataract surgery

Poster Details

First Author: W.Wan Abdul Halim MALAYSIA

Co Author(s): Y. Meng Hsien   T. Kong Yong                 

Abstract Details

Purpose:

To present a case of bilateral endophthalmitis following bilateral corneal perforation secondary to post cataract surgery induced peripheral ulcerative keratitis.

Setting:

Corneal Unit, Ophthalmology Department, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

Methods:

Case presentation of a rare case of bilateral peripheral ulcerative keratitis (PUK) complicated with corneal perforation and fungal endophthalmitis. Patient was noted to keep a very long fingernail on her right index finger.

Results:

A 78 year old lady was referred for bilateral fungal endophthalmitis with right eye perforated corneal ulcer. She has had bilateral cataract surgery performed consecutively 4 months prior. She was diagnosed to have peripheral ulcerative keratitis when she presented with progressive blurring of vision and was started on topical and systemic immunosuppression  and immunomodulating agents. She subsequently developed bilateral endophthalmitis and left corneal perforation. On further treatment at UKMMC, she was treated as exogenous endophthalmitis and subsequently developed right corneal perforation. Bilateral patch graft performed and conditions further improved with antibiotics and gradual introduction of topical and oral steroid.

Conclusions:

Severe peripheral ulcerative keratitis with perforation can easily be complicated with infective endophthalmitis especially if patient is treated with immunomodulating agents. Decision on restarting immunosuppressive agents for PUK in an infected endophthalmitis can be very challenging. Fungal infection can be transmitted from a long kept fingernail.

Financial Disclosure:

None