A 62 year-old presents with pain and redness four days after uncomplicated phacoemulsification. Vision today is 20/100, as compared to 20/20 on post-op day one.
Which is the most likely diagnosis?
- TASS
- Endophthalmitis
- Decentration of intraocular lens
- Vitreous hemorrhage
Analysis
Here there is an eye with significant injection. In particular, there is engorgement of the vessels at the limbus, indicating the presence of a ciliary flush. There is also haziness of the inferior cornea, and the presence of a subconjunctival hemorrhage. The patient also had a small hypopyon; there was significant white blood cells in the anterior chamber on slit lamp examination. Cells were also noted in the anterior vitreous.
The patient was diagnosed with endophthalmitis.
In this 4-minute video with Dr. Beeran Meghpara you will learn about:
- Specific recommendations for how to counsel a cataract surgery post-operative patient
- Which symptoms and conditions present at varying times after surgery
- How endophthalmitis presents
Cornea Coach Tip
In any patient with ocular pain a few days after an intraocular procedure, endophthalmitis needs to be ruled out.
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