Dr. Surabhi Sharma, S12798
One of the most complex situations in vitreoretinal set up is cases of acute endophthalmitis presenting to the vitreoretinal surgeon when cornea has become involved. We should go for specific investigations such as blood culture, corneal and conjunctival scrapings, Brightness scan (B scan) to rule out retinal detachment.
Therapeutic penetrating keratoplasty and pars plana vitrectomy is the only definitive modality of approach in such cases. The trochar and cannula at infusion port are inserted first without starting infusion. At this point of time if there is expulsion of contents through expulsive choroidal haemorrhage the intraocular contents are in the anterior chamber. The cornea is hazy and obstructs the surgeons view. The process is irreversible.