<p>Panophthalmitis and Orbital Inflammation with Cavernous Sinus Thrombosis Following Cataract Surgery</p>

Abstract

Background Panophthalmitis is a severe inflammation of the globe that can result as a rare complication of ophthalmic surgery. In severe cases, it may also be associated with orbital inflammation and cavernous sinus thrombosis. Purpose This case demonstrates a rare and life-threatening post-operative complication of cataract surgery. We also hope to highlight the importance of considering the relevant risk factors associated with developing potential infections after cataract surgery, including the use of corneal sutures, high-risk behaviours such as excessive eye-rubbing, and non-compliance with appointments and post-operative medications. Case Report We report the case of a 35-year-old female with severe autism and developmental delay who developed panophthalmitis, orbital inflammation and cavernous sinus thrombosis 6 weeks post cataract surgery. The likely cause was corneal suture-related microbial keratitis, and the patient required enucleation due to sepsis. Conclusion Post-surgical panophalmitis is a rapidly progressive disease that is not only sight- but life-threatening and demands urgent and intensive treatment. Consideration of early enucleation may be required to prevent deterioration in such patients.

Extensively drug-resistant Pseudomonas aeruginosa panophthalmitis from contaminated artificial tears

“…Cases complicated by globe rupture or perforation, or intractable pain or infection are treated with evisceration or enucleation. Possible complications of untreated infection include orbital abscess, superior ophthalmic vein or cavernous sinus thrombosis, meningitis, or encephalitis [1] , [5] , [6] , [7] , [8] . Chen et al concluded that multiple intravitreal treatments may be associated with lower likelihood of requiring evisceration or enucleation [9] .…”

Orbital cellulitis with panophthalmitis and scleral necrosis – a case report

“…Endogenous panophthalmitis can be from hematogenous spread of the pathogen, while exogenous panophthalmitis occurs as a consequence of ocular penetration (e.g. trauma or surgery) [ 2 ]. The case reported here is unusual in that panopthalmitis resulted from direct extension from the orbit into the globe.…”

“…Additionally, evisceration or enucleation of the globe can be done for rapidly progressing cases with no visual potential [ 5 ]. Enucleation can be especially useful in preventing and controlling life-threatening sepsis [ 2 ]. Due to the progressive nature of the disease, lack of visual potential, and the concern for other serious complications, enucleation was performed in our patient.…”

“…The severe visual and life-threatening complications of orbital cellulitis include optic neuropathy, the formation of an orbital abscess, meningoencephalitis, intracranial abscesses, venous sinus thrombosis and sepsis [ 1 ]. Panophthalmitis is a rare and serious infection of the globe that affects all the layers of the eye [ 2 ]. Coexisting orbital cellulitis and panophthalmitis is a rare clinical event with poor prognosis that must be managed as an emergency.…”