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JAMA Ophthalmology Clinical Challenge
April 2016

Chronic Recurrent Pseudophakic Endophthalmitis

Author Affiliations
  • 1Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Ophthalmol. 2016;134(4):455-456. doi:10.1001/jamaophthalmol.2015.3638

An immunocompetent woman in her 80s underwent uncomplicated cataract surgery in her right eye 4 months prior with best-corrected visual acuity (BCVA) of 20/25 OD. Two weeks prior to presentation, she reported a gradual increase in blurred vision with intermittent floaters in the right eye but denied pain or inciting events. Her BCVA was 20/50 OD. There were large keratic precipitates, 1+ anterior chamber cell and flare, and no hypopyon. Numerous white precipitates were noted on the anterior and posterior surface of a 3-piece posterior chamber intraocular lens (Figure, A). There were 2+ to 3+ anterior vitreous cells and a 2–disc area chorioretinal scar along the superior retinal arcades with extramacular drusen, but no areas of chorioretinitis (Figure, B). B-scan ultrasonography showed a posterior vitreous detachment and moderate vitreous opacities. The contralateral phakic eye showed similar drusen but was otherwise unremarkable.

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