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Corresponding Address: Jessica A. Shuen, md, Department of Emergency Medicine, Hemet Valley Medical Center, 890 W. Stetson Ave., Ste. B, Hemet, CA 92543
Affiliations
Department of Emergency Medicine, Hackensack University Medical Center, Hackensack, New Jersey
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 1Frontal view of the affected left eye with conjunctival injection and hypopyon (black
arrow).
Dr Shuen is currently affiliated with APEX Emergency Medical Group, Inc, Department of Emergency Medicine, Hemet Valley Medical Center, Hemet, California. Dr Tran is currently affiliated with the Department of Emergency Medicine, Cape Fear Valley Medical Center, Fayetteville, North Carolina.
