Endophthalmitis as a complication of protozoan-fungal keratitis in a contact lenses wearer
First Author: M.Sarnat-Kucharczyk POLAND
Co Author(s): E. Filipek M. Adamczyk- Frystacka D. Barchanowska B. Wójcik-Niklewska L. Nawrocka E. Mrukwa-Kominek
The aim is to describe a case of severe fungal keratitis in a 17-years-old female patient wearing contact lenses and the difficulties in diagnostics and treatment due to lack of exact medication.
Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland; Head: Erita Filipek, Assoc. Prof., MD, PhD, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland; Head: Ewa Mrukwa-Kominek, Prof. MD, PhD, FEBOS-CR
During ophthalmic evaluations at corneal outpatient unit and on ophthalmology department distance and near best corrected visual acuity, intraocular pressure, ultrasonography, confocal microscopy, optical coherence tomography of the cornea and macula, orbital magnetic resonance imaging were all performed.
The patient’s best corrected distance visual acuity at the initial visit was 0.5 with correction -2,5 D in the right eye and 1.0 with correction -3,0 D in the left eye. Corneal confocal microscopy revealed acanthamoeba cysts and fungal hyphae. Ulceration of the cornea, despite delayed but intensive antifungal treatment and corneal transplantation, led to endophthalmitis. Another procedure - the combination of corneal transplantation and simultaneous vitrectomy did not allow to stop the development of infection. Due to the risk of life-threatening condition, the decision was made to perform evisceration.
Contact lens wearers who disobey proper eye hygiene are under the risk of sight-threatening protozoan-fungal keratitis. If treated properly and rapidly, the progression of the infection can be stopped and thus serious ocular complications can be prevented.