Affiliation
Royal London Hospital; Royal Wolverhampton Hospitals NHS Trust; Sandwell West Birmingham NHS TrustPublication date
2022-10-28Subject
Ophthalmology
Metadata
Show full item recordAbstract
A female patient with type 2 diabetes in her 50s presented to casualty with a 1-day history of red, painful right eye. Visual acuity (VA) bilaterally was 6/12, but a right anterior uveitis was noted, with hazy fundal view. She was discharged on topical steroid and mydriatic drops with a 2-day follow-up. VA remained unchanged, but she developed right proptosis, restricted eye movements, lid swelling, relative afferent pupillary defect and an intraocular pressure (IOP) of 39 mm Hg. She was admitted and treated with intravenous and intravitreal antibiotics, intravenous antifungals and IOP-lowering drugs. Blood tests showed raised inflammatory markers and an HbA1c of 127 mmol/mol. Over her admission, right eye vision deteriorated to no light perception. A B-scan ultrasound revealed panophthalmitis and a retinal abscess. All investigations looking for a source were negative. Inflammatory markers settled, but despite aggressive treatment, the panophthalmitis did not improve. She was discharged with a follow-up to consider enucleation.Citation
Azzopardi M, Ng B, Chong YJ. Sterile endogenous panophthalmitis with uncontrolled diabetes. BMJ Case Rep. 2022 Oct 28;15(10):e252875. doi: 10.1136/bcr-2022-252875.Type
ArticlePMID
36307143Journal
BMJ Case ReportsPublisher
BMJ Publishing Groupae974a485f413a2113503eed53cd6c53
10.1136/bcr-2022-252875