Post-coronavirus disease bilateral endogenous fungal endophthalmitis with full visual acuity recovery: a case report

Increasing reports and case series describe cases of endogenous endophthalmitis (EE) following severe acute respiratory syndrome coronavirus 2 infection. Endogenous endophthalmitis is a severe ophthalmologic pathology caused by bacteremic or fungemic seeding of the eye, often in immunocompromised patients. Delayed treatment can lead to permanent visual impairment. We report the diagnosis and management of a case of fungal endogenous endophthalmitis with voriconazole and surgery that led to complete visual acuity recovery.

We present a case of post-coronavirus disease 2019 bilateral fungal endogenous endophthalmitis due to Candida albicans in a 64-year-old Caucasian male patient. Upon arrival, he had a visual acuity of 6/200 and slow pupillary light reflex. Ocular examination revealed conjunctival hyperemia, keratic precipitates, moderate vitritis with cotton wool spots, intraretinal hemorrhages, and foci of chorioretinitis.

Treatment for endogenous endophthalmitis is often delayed because cultures frequently yield negative results. Early diagnosis is key for better outcomes in endogenous endophthalmitis. This case highlights the need for a high index of suspicion for endogenous endophthalmitis in patients with coronavirus disease 2019 to ensure early diagnosis and timely intervention.