Endophthalmitis is the inflammation of the intraocular cavities, and panophthalmitis is its most severe form.1 2 3 In panophthalmitis, there is a marked inflammation of the surrounding orbital structures, manifested by severe eyelid edema, proptosis, chemosis and eye movement limitations.4 If left untreated, endophthalmitis could lead to irreversible vision loss and systemic complications.
Klebsiella ; Panophthalmitis

PURPOSE: To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. CASE SUMMARY: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. CONCLUSIONS: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; Aqueous Humor ; Blindness ; Cataract ; Cellulitis ; Cornea ; Corneal Edema ; Endophthalmitis ; Erythema ; Eye Infections ; Eyelids ; Humans ; Inflammation ; Intravitreal Injections ; Lens Implantation, Intraocular ; Male ; Necrosis ; Panophthalmitis ; Phacoemulsification ; Recurrence ; Streptococcus ; Visual Acuity ; Vitrectomy

PURPOSE: To report a case of non-clostridial gangrenous panophthalmitis extended directly from adjacent gangrenous skin infection METHODS: A 62-year-old woman, with diabetes mellitus, was admitted to ICU after explorative laparotomy for panperitonitis, retroperitoneal hemorrhage, and disseminated intravascular coagulation caused by traffic accident. She was referred to the ophthalmologic department because of necrotizing skin infection and panophthalmitis extended directly from an adjacent skin infection, which had developed after superficial abrasion on the left forehead. RESULTS: Necrotizing gangrenous skin infection with subcutaneous emphysema had rapidly progressed to her left face and there was panophthalmitis with subconjunctival gas bubbles. Proteus mirabilis, Serratia marcescens, Enterobacter aerogenes, and Enterococcus faecalis were cultured from the skin wound and aqueous humor, Acinetobacter baumannii, and Serratia marcescens were cultured from sump drainage. She died after 3 days because of sepsis, acute renal failure, and multiple organ failure. CONCLUSIONS: Physicians should always keep in mind that a serious infectious disease like non-clostridial gas gangrene can develop even from a superficial skin wound in immunocompromised patients like diabetics.
Accidents, Traffic ; Acinetobacter baumannii ; Acute Kidney Injury ; Aqueous Humor ; Communicable Diseases ; Diabetes Mellitus ; Disseminated Intravascular Coagulation ; Drainage ; Enterobacter aerogenes ; Enterococcus faecalis ; Female ; Forehead ; Gas Gangrene ; Hemorrhage ; Humans ; Immunocompromised Host ; Laparotomy ; Middle Aged ; Multiple Organ Failure ; Panophthalmitis* ; Proteus mirabilis ; Sepsis ; Serratia marcescens ; Skin ; Subcutaneous Emphysema ; Wounds and Injuries

We performed a retrospective study on evisceration and enucleation operated at Chosun University hospital and Chonnam University hospital during the period of 10 years from January 1982 to December 1991. The total number of cases was 550. The incidence was mow common in male. The male and female ratio was 1.85: 1(Male 64.9%, Female 35.1%). The frequency of enucleation and evisceration was as follows trauma; 281 cases(51.1%), glaucoma; 76 cases(13.8%), corneal ulcer; 69 cases(12.6%), panophthalmitis; 43 cases(7.8%), tumor; 33 cases(6.0%), phthisis bulbi, 26 cases(4.7%), others; 22 cases(4.0%). The most frequent cause of the trauma whitch had been eviscerated or enucleated was traffic accident; 129 cases(45.9%), followed by violence; 73 cases(25.9%), industrial accident, 37 cases(13.2%), toy and pencil; 19 cases(6.8%), sports; 12 cases(4.3%), unknown; 11 cases(3.9%). The age-related incidence was peak in the third decades 86 cases(15.6%), followed by fifth decades 85 cases(15.5%) and fourth and sixth decades 82 cases(14.9%), respectively. The mean annual incidince rate was significantly greater among males than females: 2.33 per 100,000 population and 1.93 per 100,000 population, respectively. The overall mean annual rate was 2.13.
Accidents, Occupational ; Accidents, Traffic ; Corneal Ulcer ; Female ; Glaucoma ; Gwangju* ; Humans ; Incidence ; Jeollanam-do* ; Male ; Panophthalmitis ; Play and Playthings ; Retrospective Studies ; Sports ; Violence

We performed a retrospective study on evisceration and enucleation operated at Chosun University hospital and Chonnam University hospital during the period of 10 years from January 1982 to December 1991. The total number of cases was 550. The incidence was mow common in male. The male and female ratio was 1.85: 1(Male 64.9%, Female 35.1%). The frequency of enucleation and evisceration was as follows trauma; 281 cases(51.1%), glaucoma; 76 cases(13.8%), corneal ulcer; 69 cases(12.6%), panophthalmitis; 43 cases(7.8%), tumor; 33 cases(6.0%), phthisis bulbi, 26 cases(4.7%), others; 22 cases(4.0%). The most frequent cause of the trauma whitch had been eviscerated or enucleated was traffic accident; 129 cases(45.9%), followed by violence; 73 cases(25.9%), industrial accident, 37 cases(13.2%), toy and pencil; 19 cases(6.8%), sports; 12 cases(4.3%), unknown; 11 cases(3.9%). The age-related incidence was peak in the third decades 86 cases(15.6%), followed by fifth decades 85 cases(15.5%) and fourth and sixth decades 82 cases(14.9%), respectively. The mean annual incidince rate was significantly greater among males than females: 2.33 per 100,000 population and 1.93 per 100,000 population, respectively. The overall mean annual rate was 2.13.
Accidents, Occupational ; Accidents, Traffic ; Corneal Ulcer ; Female ; Glaucoma ; Gwangju* ; Humans ; Incidence ; Jeollanam-do* ; Male ; Panophthalmitis ; Play and Playthings ; Retrospective Studies ; Sports ; Violence

Tuberculous panophthalmitis is, at present, a rare disease and a recent study has revaled that the incidence has decreased to less 1 percent in the causes of granulomatous uveitis. But ocular tuberculosis is still one of frequent causes of uveitis in the world. Ocular tuberculosis may be divided in two main groups with regard to clinical manifestations; one is a simple tuberculous infection, and the other is an allergic reaction depending on the immunological reaction of the patient. We have experienced a 14 year old female who had clinical signs of unilateral panophthalmitis with a subconjunctival mass but no evidence of systemic tuberculosis. The pathologic examination revealed that a chronic granulomatous inflammation was present in the retina, choroid, and sclera with caseous necroses. The same pathologic changes were present in the subconjunctival mass which was closely associated with the markedly thin sclera. It may be, therefore, concluded that the subconjunctival granuloma was secondary to the scleral perforation in tuberculous panophthalmitis.
Adolescent ; Choroid ; Female ; Granuloma* ; Humans ; Hypersensitivity ; Incidence ; Inflammation ; Necrosis ; Panophthalmitis* ; Rare Diseases ; Retina ; Sclera ; Tuberculosis ; Tuberculosis, Ocular ; Uveitis

Tuberculous panophthalmitis is, at present, a rare disease and a recent study has revaled that the incidence has decreased to less 1 percent in the causes of granulomatous uveitis. But ocular tuberculosis is still one of frequent causes of uveitis in the world. Ocular tuberculosis may be divided in two main groups with regard to clinical manifestations; one is a simple tuberculous infection, and the other is an allergic reaction depending on the immunological reaction of the patient. We have experienced a 14 year old female who had clinical signs of unilateral panophthalmitis with a subconjunctival mass but no evidence of systemic tuberculosis. The pathologic examination revealed that a chronic granulomatous inflammation was present in the retina, choroid, and sclera with caseous necroses. The same pathologic changes were present in the subconjunctival mass which was closely associated with the markedly thin sclera. It may be, therefore, concluded that the subconjunctival granuloma was secondary to the scleral perforation in tuberculous panophthalmitis.
Adolescent ; Choroid ; Female ; Granuloma* ; Humans ; Hypersensitivity ; Incidence ; Inflammation ; Necrosis ; Panophthalmitis* ; Rare Diseases ; Retina ; Sclera ; Tuberculosis ; Tuberculosis, Ocular ; Uveitis

Tuberculosis, once thought to be the most common cause of uveal is now thought to be a relatively rare cause of ocular disease. This is because of a decreased incidence of tuberculosis as well as a lessened emphasis on its diagnosis. Tuberculosis of uveal tract has long been a controversial subject in ophthalmology. Several factors have been implicated including the marked pleomorphism of the lesions, owing to variations in the virulence of the invading organisms, host resistance, and the presence or absence of host immunity. Solitary choroidal tuberculoma is rare and characterized as gradually growing until it resembles a tumor projecting as a round white or yellowish globular mass into the cavity of the eye. It may progress continuously and so finally, in the absence of treatment, the sclera is involved and perforation results which is followed by phthisis bulbi or pyogenic infection and panophthalmitis. We have experienced a 19-year old female who had a solitary choroidal tumor like lesion, which about 17 months later resulted in scleral perforation, in the posterior pole of the left eye. We performed enucleation of the left eyeball under the clinical diagnosis of the maligant melanoma associated with scleral perforation and obtained the histopathological diagnosis of ocular tuberculosis.
Choroid ; Diagnosis ; Female ; Humans ; Incidence ; Melanoma ; Ophthalmology ; Panophthalmitis ; Sclera ; Tuberculoma ; Tuberculosis ; Tuberculosis, Ocular ; Virulence ; Young Adult

In a world, ocular infection of Pseudomonas has been found in premature infants. This is so serious that corneal perforation and panophthalmitis are developed. And septicemia is developed. In these days, hospital infection due to pseudomonas tends to increasese. We experienced one case of pseudomonas dacryocystitis in a normal full term infant. At first, we diagnosed it as a blenorrhea neonatorum due to pseudomonas infection. And the smear of vagina of his mother was examined by Gram stain and culture. But, pseudomonas was not found. So, we considered that it was because of hospital infection. The patient was treated with carbenicillin 400 mg/day intramuscularly and 0.5% chloramphenicol solution everyone hour topically for 2 weeks. During this time there wa.s no improvement. After then we found obstruction of nasolacrimal ducts and performed probing once. After that this case was cured.
Carbenicillin ; Chloramphenicol ; Corneal Perforation ; Cross Infection ; Dacryocystitis* ; Eye Infections ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Mothers ; Nasolacrimal Duct ; Panophthalmitis ; Pseudomonas Infections ; Pseudomonas* ; Sepsis ; Vagina

In the past decade, a decrease in the incidence of endophthalmitis has been attributed to many factors-surgical technic, delicate surgical Instruments, sterile technic, and antibioticsetc. On the other hand, immunosuppressive agents and drug addiction and/or abuse may be contributing to rise in the number of endophthalmitis like one of our cases. Recently, we have experienced three cases of endophthalmitis, each case has different etiologic causes-multiple myeloma, meningococcal meningitis, and subacute bacterial endocarditis. By case and chart review, we feels not enough to do reemphasize not only early recognition and early aggressive systemic and topical therapy, which are the most necessary, and may prevent blinding complication, more over panophthalmitis, but a certain common ocular symptoms, which may playa role as a early developing sings of endophthalmitis.
Endocarditis, Subacute Bacterial ; Endophthalmitis* ; Hand ; Immunosuppressive Agents ; Incidence ; Meningitis, Meningococcal ; Panophthalmitis ; Substance-Related Disorders ; Surgical Instruments