A Case of Phacoanaphylactic Uveitis Presenting as Endophthalmitis

Ji Hye Kim; Woong Sun Yoo; Min Gui Kong; Yong Seop Han; In Young Chung; Seong Wook Seo; Ji Myong Yoo; Seong Jae Kim

doi:10.3341/jkos.2016.57.9.1480

Journal List > J Korean Ophthalmol Soc > v.57(9) > 1010407

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Kim, Yoo, Kong, Han, Chung, Seo, Yoo, and Kim: A Case of Phacoanaphylactic Uveitis Presenting as Endophthalmitis

Case Report

J Korean Ophthalmol Soc 2016;57(9):1480-1483.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.9.1480

A Case of Phacoanaphylactic Uveitis Presenting as Endophthalmitis

Ji Hye Kim, MD¹, Woong Sun Yoo, MD¹, Min Gui Kong, MD^1,², Yong Seop Han, MD, PhD^1,², In Young Chung, MD, PhD^1,², Seong Wook Seo, MD, PhD^1,², Ji Myong Yoo, MD, PhD^1,², Seong Jae Kim, MD, PhD^1,²

¹Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea

²Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea

Address reprint requests to Seong Jae Kim, MD, PhD Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 52727, Korea Tel: 82-55-750-8171, Fax: 82-55-758-4158 E-mail: maya12kim@naver.com

Received 16 June 2016 Revised 30 June 2016 Accepted 16 August 2016

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 phacoanaphylactic uveitis presenting as endophthalmitis.

Case summary

A 77-year-old woman presented with sudden visual disturbance and painful red right eye. She did not have a history of trauma or surgery in her right eye. Her best corrected visual acuity was hand movement in the right eye and log MAR 0.22 in the left eye; intraocular pressure was 27 mm Hg in the right eye and 15 mm Hg in the left eye. Slit-lamp examination revealed corneal edema and prominent inflammation with hypopyon in the anterior chamber. B-scan showed vitreous opacity behind the lens. Based on the diagnosis of endophthalmitis, anterior chamber paracentesis and irrigation were performed. After irrigation, a hypermature cataract with intact anterior capsule was observed. Therefore, we performed extracapsular cataract extraction and intravitreal antibiotics injection. Gram staining of the aqueous humor revealed numerous macrophages filled with lens protein but no organisms. She was treated with hourly topical corticosteroid and an antibiotic agent. One month later, the anterior chamber is clear, and the cultures remained negative.

Conclusions

We report a case of spontaneous phacoanaphylactic uveitis presenting as endophthalmitis in a patient with no history of eye trauma or surgery.

Keywords: Anterior chamber paracentesis, Endophthalmitis, Macrophages, Phacoanaphylactic uveitis

References

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Figure 1.

Anterior segment photograph and ultrasonograph. (A, B) At initial presentation first visit, slit-lamp examination revealed marked corneal edema, and severe anterior chamber inflammation with hypopyon in the right eye. (C) B-scan revealed a scanty vitreous opacity in the posterior the lens.

Figure 2.

Light microscope examination of aqueous humor revealed the presence of macrophage with intracystoplasmic lens material (magnification ×1,000: Papanicolaou staining).

Figure 3.

Anterior segment photograph and Fundus photograph. 1 month later Anterior segment photograph (A) and fundus photograph (B) reveals no cellular inflammatory reaction in the anterior chamber and macular degeneration in the fundus.

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