Question

At 68-year woman presents to you with 5 days after undergoing an uncomplicated cataract surgery with a red, painful eye with blurred vision. Examination findings are shown in the photograph. Your diagnosis for this patient is:

1) Cataract complications
2) Endophthalmitis
3) Corneal erosion
4) Allergic conjunctivitis

Answer 1

The patient's symptoms of a red, painful eye and blurred vision post-cataract surgery most likely indicate endophthalmitis, an ophthalmic emergency that requires immediate referral to an ophthalmologist for treatment to prevent blindness.

Step-by-step explanation:

The symptoms described indicate that the most likely diagnosis for the 68-year-old woman with a red, painful eye and blurred vision post-cataract surgery is endophthalmitis. This condition is a severe inflammation of the internal coats of the eye and can result from bacterial or fungal infections following intraocular surgeries. Unlike conjunctivitis, which primarily affects the conjunctiva and is associated with discharge but not necessarily with severe pain or vision loss, endophthalmitis is characterized specifically by pain, redness, and decreased vision, indicating a more serious intraocular process. Allergic conjunctivitis tends to involve itchiness and bilateral redness without severe pain or vision changes, while corneal erosion would be associated with a history of trauma or foreign body sensation rather than primarily with pain and blurred vision.

An immediate referral to an ophthalmologist is crucial for proper evaluation and management, which may include intraocular cultures, antibiotics, and possibly surgery. This condition is an ophthalmic emergency due to the risk of rapid progression to blindness.