Traumatic endophthalmitis with intraocular metallic foreign body

Abstract

Background: Post-traumatic endophthalmitis with retained intraocular foreign body is a severe complication of open globe injuries. It is generally associated with poor visual outcome and requires prompt and adapted management. Case report: A 39-year-old male patient presented with open globe injury of the right eye due to a metallic foreign body projection. He was a victim of a neglected work accident 10 days ago when hammering a metallic bar. Visual acuity on admission was LP (+) in the right eye. The Slit-lamp examination revealed perikeratic injection, edematous cornea and severe inflammation of the anterior chamber with hypopyon. Ocular ultrasound showed a heterogeneous vitreous organization compatible with a vitreous abscess. Orbito-cerebral CT scan revealed a retained intraocular metallic foreign body located in the posterior segment, within the vitreous humor. The patient received local and general antibiotherapy associated with intravitreal injections of vancomycin and ceftazidime followed by a vitrectomy to remove the intraocular foreign body. The visual outcome was poor with an evolution towards phtysis bulbi. The aim of this case report is to study the risk factors of post-traumatic endophthalmitis with retained intraocular foreign body and to examine treatment principles and visual outcome of this severe complication.