This patient underwent a complicated phacoemulsification with vitreous loss. He presented to the eye hospital four days later with severe ocular pain and decreased vision. The appearance of the eye is as shown above. 

What would you do if you were the casualty doctor on-call?

Answer
The most important diagnosis in this case is acute post-operative 
endophthalmitis and I would treat this as an ocular emergency.
The patient needs to be admitted for intravitreal biopsy and 
antibiotics.
The other possibility may be severe uveitis especially if there is
retained lens material. However, trial of steroid is not recommended
as delayed treatment of endophthalmitis can lead to severe visual loss.

 
 

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