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Bilateral endogenous endophthalmitis complicated by scleral perforation: an unusual presentation
  1. Prerna Sinha1,
  2. Upasna Sinha2,
  3. Amit Raj1 and
  4. Binod Kumar Pati3
  1. 1Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
  2. 2Department of Radiology, AIIMS Patna, Patna, Bihar, India
  3. 3Department of Microbiology, All India Institute of Medical Sciences, Patna, Bihar, India
  1. Correspondence to Dr Amit Raj; dramitraj{at}


Endogenous endophthalmitis complicated by necrotising scleritis has rarely been reported in the literature. We, hereby, report a case of bilateral scleral perforation with endogenous endophthalmitis in an 87-year-old female patient with diabetes who presented as bilateral orbital cellulitis. Systemic workup ruled out autoimmune aetiology. The culture and sensitivity of exudates exuding from the scleral perforation showed Escherichia coli. The Patient was managed conservatively with parenteral and topical antibiotics along with steroid, but the vision could not be salvaged. The report emphasizes on atypical presentation of endogenous endophthalmitis. In old and immunosuppressed individuals presenting with a clinical picture of bilateral orbital cellulitis with profound vision loss, endogenous endophthalmitis should be ruled out.

  • retina
  • pain
  • diabetes
  • urinary tract infections

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  • Contributors PS was involved in the acquisition of data and drafting of manuscript. US helped with data analysis and interpretation and approval of final version of manuscript. AR has conceptualised and designed the study and helped in critical revision and finalising the manuscript. BKP has helped in data interpretation and finalising the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.