EyeRounds Online Atlas of Ophthalmology

Contributor:
William Charles Caccamise Sr,MD, Retired Clinical Asst Prof of Ophthal. U.of Rochester School of Medicine & Dentistry

Category: Cornea
Diagnosis: spontaneous rupture of a descemetocele with resulting panophthalmitis

spontaneous rupture of a descemetocele with resulting panophthalmitis

Image Comments:

An extreme rarity, even at the Kurji Holy Family Eye Clinic: spontaneous rupture of a descemetocele. That was followed by the development of an endophthalmitis which progressed to the purulent panophthalmitis seen in the photograph.Although some ophthalmologists prefer enucleation in a case of this type, Dr. Caccamise preferred evisceration. It has been postulated that severing the optic nerve during an enucleation may increase the chances of spread of infection to the brain with a resultant meningoencephalitis. Others have stated - legitimately or not - that in cases of purulent panophthalmitis, evisceration protects the optic nerve/brain barrier and has not led to sympathetic ophthalmia. After systemic antibiotics had been administered, the patient was taken to the O.R. and , under general anesthesia , the eye was eviscerated. Recovery was uncomplicated. The patient had immediate and permanent relief from an extremely uncomfortable condition.

spontaneous rupture of a descemetocele with resulting panophthalmitis


spontaneous rupture of a descemetocele with resulting panophthalmitis


spontaneous rupture of a descemetocele with resulting panophthalmitis


 

 

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