Endophthalmitis due to a retained intraocular metallic object

Area of Science:

• Ophthalmology
• Emergency Medicine
• Infectious Diseases

Background:

• Endophthalmitis is a severe intraocular infection requiring urgent management.
• Diagnosis in the emergency department (ED) can be challenging due to nonspecific symptoms and specialized equipment needs.

Observation:

• A 42-year-old male presented with eye pain and blurred vision post-traumatic ocular injury.
• Initial fluorescein staining showed a corneal abrasion, treated with ointment.
• A subsequent ED visit revealed signs of endophthalmitis, with a retained metallic foreign body found in the anterior chamber via slit lamp examination.

Findings:

• The initial diagnosis of corneal abrasion was incomplete.
• A retained intraocular foreign body was the underlying cause of the endophthalmitis.
• Delayed diagnosis and treatment led to severe inflammation and vision compromise.

Implications:

• Emphasizes the critical role of a thorough slit lamp examination in all ocular trauma cases.
• Highlights the need for advanced diagnostic capabilities in the ED for ocular emergencies.
• Underscores the importance of prompt treatment with intravitreal antibiotics for endophthalmitis to preserve vision.