Bilateral corneal ulcers and endophthalmitis after eyelid surgery due to multi-drug resistant mixed infections

• Published in: TNOA Journal of Ophthalmic Science and Research Vol. 60; no. 4; pp. 321 - 322
• Main Authors: Natarajan, Radhika, Bhende, Muna, Giridhar, Divya
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.01.2022; Wolters Kluwer Medknow Publications
• Subjects: bilateral infection; corneal infiltrates with endophthalmitis; entropion surgery; multi-drug resistance; multi-drug resistance; Bilateral infection; corneal infiltrates with endophthalmitis; entropion surgery
• ISSN: 2589-4528; 2589-4536; 2589-4528
• DOI: 10.4103/tjosr.tjosr_42_22

Exogenous infective endophthalmitis is extremely rare after eyelid surgery. A 65-year-old lady presented with bilateral corneal infiltrates and severe anterior chamber exudation after bilateral senile entropion correction. There were multiple fluffy exudates in both the anterior chambers. The left eye was pseudophakic, with yellowish fundal glow. Ultrasonography revealed moderately reflective dot echoes in both eyes. Corneal scraping showed yeast in the right eye. Culture grew Pseudomonas aeruginosa resistant to all drugs except imipenem. Systemic tests for endogenous endophthalmitis were negative. She was started on 5% natamycin and 0.5% imipenem eye drops hourly in both eyes, as well as intravenous imipenem twice a day for five days with supportive treatment. Complete resolution of infection was achieved at one month. The rare bilateral presentation of extra and intraocular infection after entropion surgery, mixed and resistant causative organisms and anterior chamber exudates being disproportionately more than corneal involvement are the unique features of this case.