Visual Diagnosis in Emergency Medicine| Volume 58, ISSUE 6, e259-e260, June 2020

Acute Post–Cataract Surgery Vision Loss

      A 78-year-old man with a medical history significant for hypertension and type 2 diabetes mellitus presented to the emergency department with loss of vision in the left eye. The day before presentation, he began to experience blurry vision in the left eye that progressed to a full loss of vision, reporting at the time of presentation that he could only see lights and shapes. He was also experiencing mild pain in the left eye. The right eye was asymptomatic. The patient reported that had unilateral left eye cataract surgery 5 days before presentation to the emergency department. After the procedure, he had been taking prednisone and was prescribed flurbiprofen eye drops 3 times a day. It was unclear whether he had also been on antibiotic eye drops after the procedure. He denied fevers, chills, nausea, vomiting, headache, weakness, numbness, or other complaints. Eye examination revealed left eye conjunctival injection, purulent discharge, and hypopyon (Figure 1). Left eye visual acuity was 20/100; he was able to see only light and shapes; however, extraocular movements were intact. His laboratory results revealed no leukocytosis and a glucose level of 275 mg/dL. The rest of the complete blood cell count and chemistry panel was unremarkable.
      Figure thumbnail gr1
      Figure 1Frontal view of the affected left eye with conjunctival injection and hypopyon (black arrow).
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