Phacoemulsification in isolated endogenous Candida albicans anterior uveitis with lens abscess in an intravenous...

Area of Science:

• Ophthalmology
• Infectious Diseases
• Toxicology

Background:

• Intravenous drug use is associated with various systemic and ocular complications.
• Methadone substitution therapy, while beneficial, carries risks if misused via injection.
• Candida albicans is a common opportunistic pathogen that can cause severe infections.

Observation:

• A 31-year-old former intravenous drug user on methadone substitution therapy self-injected methadone mixed with orange juice.
• The patient presented with isolated metastatic anterior uveitis caused by Candida albicans.
• Despite systemic and local antifungal treatment, a lens abscess developed.

Findings:

• The anterior uveitis initially responded to antifungal therapy.
• Surgical intervention, including phacoemulsification and intraocular lens implantation, was necessary due to lens abscess formation.
• The patient achieved 20/20 visual acuity after surgical management.

Implications:

• Persistent intravenous drug or substitution therapy abuse should be considered in patients with a history of injection drug use presenting with uveitis.
• Early diagnosis and prompt, adequate antifungal and surgical treatment are crucial for preventing widespread Candida albicans endophthalmitis and preserving visual acuity.
• This case underscores the importance of a comprehensive approach to managing ocular infections in individuals with a history of substance abuse.