Endophthalmitis Secondary to Occult Intraocular Eyelashes Following Perforating Gunshot Injury: A Case Report

Hammouda Hamdy Ghoraba,1 Mahmoud Leila,2 Hashem H Ghoraba,1 Haithem Maamoun Abdelfattah,3 Emad Eldin Mohamed Elgemai4 1Retina Department, Magrabi Eye Hospital, Tanta, Egypt; 2Retina Department, Research Institute of Ophthalmology, Giza, Egypt; 3Ophthalmology Department, Benha Teaching Hospital, Benha, Egypt; 4Ophthalmology Department, Damanhour Teaching Hospital, Damanhour, EgyptCorrespondence: Mahmoud Leila, Retina Department, Research Institute of Ophthalmology, 2 Al-Ahram Street, Giza, Egypt, Email mahmoudleila@yahoo.comPurpose: This is a retrospective case report in which we describe our findings in two cases of endophthalmitis associated with perforating gunshot injury, in which we documented intraocular intrusion of multiple eyelashes as a plausible source of infection.Patients and Methods: Two male patients, 22 and 29 years old, respectively, presented with endophthalmitis following primary repair of rupture globe secondary to gunshot injury. Both patients had vitrectomy and silicone oil injection. Preoperative imaging and intraoperative findings confirmed the perforating nature of the projectile.Results: In both patients, we detected eyelashes that were concealed either in the pars plana region or within vitreous exudates. Silicone oil was not removed in both patients to prevent phthisis bulbi and because there was no potential for visual improvement. The postoperative course in both cases was uneventful.Conclusion: Gunshot injuries can inoculate eyelashes impregnated with infectious microorganisms into the eye. In cases presenting with endophthalmitis associated with a gunshot injury, we recommend meticulous examination of the posterior segment and the pars plana region during vitrectomy to exclude the presence of occult lashes.Keywords: gunshot injury, endophthalmitis associated with perforating IOFB, post-traumatic endophthalmitis, case report