DR. AGRIMA BHATIA

DR. ANJALI MAHESHWARI, DR.HS TREHAN

Abstract

51 years old female with no known co morbidities reported with insidious onset, painless, diminution of vision OS.BCVA was 2/60. Anterior chamber had KPs, 3 + cells. Posterior segment-Grade 2 haze, inferiorly localized dense yellowish vitreous opacities. First differential was endogenous endophthalmitis. Second was pars planitis but AC inflammation was more than usual. Vitreous biopsy revealed polymicrobial infection-Gram positive cocci, Gram negative bacilli and fungus, on smear only. Culture showed no growth leading to treatment dilemma. Intravitreal injections of ceftazidime, vancomycin and voriconazole were given. Vitreous opacities regressed, AC inflammation settled and BCVA improved to 6/9.This case is interesting as tools to aid diagnosis caused diagnostic dilemma. The decision making and uncertainties in managing this case will be discussed and comments invited.