MANAGEMENT OF AN ATYPICAL CASE OF POSTOPERATIVE ENDOPHTHALMITIS PRESENTING AS ANGLE-CLOSURE GLAUCOMA

The purpose of this study was to report an atypical presentation of postoperative endophthalmitis after cataract surgery that initially presented as angle-closure glaucoma and to discuss challenges with the case management because of the unusual presentation and patient noncompliance.

This was an observational case report. B-scan ultrasound and ultrasound biomicroscopy.

A 69-year-old White man with a 1-week history of uncomplicated cataract surgery was referred to our glaucoma clinic because of vision loss and concern for angle-closure glaucoma. Anterior segment examination showed 360 degrees of flat anterior chamber with no hypopyon. A diagnosis of postoperative endophthalmitis was established when a B-scan ultrasound showed dense vitreous opacities. The patient underwent a pars plana vitrectomy, anterior chamber reformation, peripheral iridectomy, and intravitreal injection of antibiotics for treatment of endophthalmitis in the presence of an angle-closure glaucoma with good visual recovery.

A low threshold for suspicion of endophthalmitis is needed after any routine intraocular procedure. An atypical presentation may masquerade as another pathology that delays the true diagnosis and treatment. Timely intervention in postoperative endophthalmitis is crucial in preserving vision.