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Abstract #105032 Published in IGR 23-2
Management of an atypical case of post-operative endophthalmitis presenting as angle-closure glaucoma
Liao A; Xu LT; Yeh S; Yan JRetinal cases & brief reports 2022; 0:
BACKGROUND/PURPOSE: To report an atypical presentation of postoperative endophthalmitis after cataract surgery that initially presented as angle-closure glaucoma and to discuss challenges with the case management due to the unusual presentation and patient non-compliance. METHODS: Observational case report. B-scan ultrasound and ultrasound biomicroscopy. RESULTS: A 69-year-old Caucasian male with a 1-week history of uncomplicated cataract surgery was referred to our glaucoma clinic due to vision loss and concern for angle closure glaucoma. Anterior segment exam showed 360 degrees of flat anterior chamber (AC) with no hypopyon. A diagnosis of postoperative endophthalmitis was established when a B-scan ultrasound showed dense vitreous opacities. The patient underwent a pars plana vitrectomy (PPV), AC reformation, peripheral iridectomy, and intravitreal injection of antibiotics for treatment of endophthalmitis in the presence of an angle-closure glaucoma with good visual recovery. CONCLUSION: A low threshold for suspicion of endophthalmitis is needed after any routine intraocular procedure. An atypical presentation may masquerade as another pathology that delays the true diagnosis and treatment. Timely intervention in postoperative endophthalmitis is crucial in preserving vision.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
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