Endophthalmitis Post Traumatic Corneal Laceration: A COVID-19 Delayed Treatment Impact, What Should We Do?

Abstract

Introduction: Endophthalmitis can occurs through trauma. One of its risk factors are rural trauma, wound size, and delayed repair.

Objectives: Lacinia at quis risus sed vulputate odio ut enim. Orci porta non pulvinar neque laoreet suspendisse interdum. Consequat mauris nunc congue nisi vitae suscipit. Morbi quis commodo odio aenean.

Methods: Three years old girl’s left eye was stabbed by scissors. Initially, this patient was handled by a general practitioner and given antibiotic eye drops. Three days later, she had decreased vision and COVID-19 symptoms then were referred to our center. The patient has a 0.5x10mm full-thickness corneal laceration, corneal melting, and thick fibrin membrane in her left eye. Following the COVID-19 screening result found negative, corneal suturing was performed in the ER operating room. After surgery, LE USG has shown vitreous opacity and persistent corneal white membrane. Therefore, the patient was given ceftazidime intravitreal afterward. The white membrane was no longer active one month after surgery, but the left eye was no light perception. Similar results were obtained in 6 months and 1 year postoperatively.

Results: Delay in the initial action of more than 24 hours is a risk factor for post-traumatic endophthalmitis and COVID-19 often causing delays because of patient afraid of going to hospital or referral problems. The presence of hypopyon/fibrin membranes in the anterior and a vitreous opacity in the posterior segment are markers for enforcing endophthalmitis. Daily postoperative follow-up is needed, and intravitreal antibiotics may be considered if there is no improvement within 48-72 hours.

Conclusions: Early intravitreal antibiotics may be a solution for this condition. In addition, hospital referral management needs to be modified to adapt to changing global conditions that occur today.