Panophthalmitis and Orbital Inflammation with Cavernous Sinus Thrombosis Following Cataract Surgery

• Published in: International medical case reports journal Vol. 13; pp. 569 - 572
• Main Authors: Marinos, Emmanuel, McCall, Dominic, Tumuluri, Krishna, Rowe, Neil, Do, Helen
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Abscesses; Case Report; Case reports; Cataract extraction; Cataracts; cavernous sinus thrombosis; Cellulitis; Cornea; enucleation; Erythema; Eye surgery; Health aspects; Hospitals; Infection; Inflammation; Methicillin; orbital cellulitis; Orbits; panophthalmitis; Pediatrics; Risk factors; Sepsis; Sinuses; Streptococcus infections; suture abscess; Sutures; Thrombosis; Australia; orbital cellulitis; cavernous sinus thrombosis; panophthalmitis; suture abscess; enucleation
• ISSN: 1179-142X; 1179-142X
• DOI: 10.2147/IMCRJ.S274140

Panophthalmitis is a severe inflammation of the globe that can result as a rare complication of ophthalmic surgery. In severe cases, it may also be associated with orbital inflammation and cavernous sinus thrombosis.
This case demonstrates a rare and life-threatening post-operative complication of cataract surgery. We also hope to highlight the importance of considering the relevant risk factors associated with developing potential infections after cataract surgery, including the use of corneal sutures, high-risk behaviours such as excessive eye-rubbing, and non-compliance with appointments and post-operative medications.
We report the case of a 35-year-old female with severe autism and developmental delay who developed panophthalmitis, orbital inflammation and cavernous sinus thrombosis 6 weeks post cataract surgery. The likely cause was corneal suture-related microbial keratitis, and the patient required enucleation due to sepsis.
Post-surgical panophalmitis is a rapidly progressive disease that is not only sight- but life-threatening and demands urgent and intensive treatment. Consideration of early enucleation may be required to prevent deterioration in such patients.