Spontaneous Eyeball Rupture in a 94-Year-Old Patient

Dae Il Park; Jong Seo Park; Hae Youn Kang; Helen Lew

doi:10.3341/jkos.2011.52.6.734

Journal List > J Korean Ophthalmol Soc > v.52(6) > 1009065

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Park, Park, Kang, and Lew: Spontaneous Eyeball Rupture in a 94-Year-Old Patient

Original Article

J Korean Ophthalmol Soc 2011;52(6):734-737.

Published online: 31 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.6.734

Spontaneous Eyeball Rupture in a 94-Year-Old Patient

Dae Il Park, MD¹, Jong Seo Park, MD¹, Hae Youn Kang, MD², Helen Lew, MD¹

¹Department of Ophthalmology, Bundang CHA Hospital, CHA University, Seongnam, Korea

²Department of Pathology, Bundang CHA Hospital, CHA University, Seongnam, Korea

Address reprint requests to Helen Lew, MD, Department of Ophthalmology, Bundang CHA Hospital #351 Yatap-dong, Bundang-gu, Seongnam 463-712, Korea Tel: 82-31-780-5330, Fax: 82-31-780-5333, E-mail: eye@cha.ac.kr

Received 22 July 2010 Revised 27 January 2011 Accepted 12 April 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of spontaneous eye ball rupture without trauma in a 94-year-old patient.

Case summary

A 94-year-old female patient diagnosed with cataract in both eyes 20 years was referred to this ophthalmologic department for treatment consultation of a painful left eye with spontaneous bleeding. She has used anti-cataract eye drops and artificial tears three times a day for several years without consulting a doctor. Fifteen days prior to presentation, the patient suffered severe left eyeball pain and headache and was diagnosed with acute angle-closure glaucoma secondary to hypermature cataract. She underwnet eviceration after ocular examination and systemic evaluation. Surgical findings included a thin cornea at the inferior limbus and protruding intraocular tissues. Additionally, the eyeball was filled with a blood clot from a choroidal hemorrhage. Morganella morganii were grown in a bacterial swap culture, and a corneal biopsy revealed suppurative inflammation.

Conclusions

In old age, a thin corneal limbus due to infection and complicated acute angle-closure glaucoma can cause massive suprachoroidal hemorrhage with spontaneous eyeball rupture.

Keywords: Glaucoma, Morganella morganii, Preservative eyedrops, Spontaneous eyeball rupture, Suprachoroidal hemorrhage

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Figure 1.

(A) Ruptured left eye ball with protruded intraocular tissues and conjunctival hemorrhage are noted in the 94-year-old female patient. (B) Axial image of orbital CT shows irregular anterior margin of the left eye ball filled with hemorrhage.

Figure 2.

Intraoperative findings. (A) Protruding intraocular tissues are noted. (B) The cornea is very thin and perforated along the inferior corneoscleral junction. (C) After removal of intra ocular tissues, the posterior part is intact.

Figure 3.

(A) Choroidal vessels (arrow) with blood clots, inflammatory cells (arrowhead) surrounding vessel wall are noted (H&E stain, ×200). (B) Corneal biopsy specimen presents diffuse supprative inflammation in the stroma. Stromal infiltrations of many lymphocytes are noted (arrowhead) (H&E stain, ×200).

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