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Can You Guess May's Mystery Condition?
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Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
Fungal Endophthalmitis
Written by Stephan Chiu, MD. Photo by Connie Zhen. Both are at the Stein Eye Institute, University of California, Los Angeles.
A 79-year-old woman who had a Boston keratoprosthesis (KPro) Type 1 in her left eye presented with an infiltrate under the front optic of the KPro. The infiltrate was cultured and was positive only for Staphylococcus epidermidis. The patient was started on topical vancomycin but did not improve. She subsequently developed vitreous opacities, visible on fundus imaging (Fig. 1). The “string of pearls” appearance of the opacities raised the suspicion of fungal endophthalmitis. She underwent intravitreal injection with voriconazole and subsequent pars plana vitrectomy several days later. The vitreous aspirates were notable for hyphae on fungal staining, making Candida albicans keratitis with subsequent endophthalmitis the likely diagnosis.
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