PMC4010639_01
Ischemia of lower eyelid, upper eyelid margins, and anterior segment seen 24 hours after admission.
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On exploration, necrosis was noted in the upper eyelid tarsus, lower eyelid, limbus, and conjunctiva (Figure 1).
Further necrosis of eyelid, as well as scleral necrosis, seen 4 days after gold weight removal.
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Four days following removal of the gold weight, the patient developed fever of 38 C, chills, tachycardia, and extreme restlessness, suggesting systemic involvement, as well as thinning and necrosis of the sclera, worsening of eyelid swelling and necrosis (Figure 2).
Photograph taken during evisceration surgery showing the white, necrotic tissue.
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The patient was taken again to the operating room where evisceration and debridement of necrotic tissue were performed (Figure 3).
Histopathologic examination from evisceration (Hematoxylin and eosin stain, x40) revealing an acute nonspecific necrotizing inflammation involving the retina and uveal tissue (composed of necrotic segments), and a dense inflammatory infiltrate composed mainly of polymorphonuclear cells.
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Histopathologic examination revealed acute nonspecific necrotizing panophthalmitis (Figure 4).
The contracted socket as seen on follow-up of the patient 6 months post-evisceration.
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On repeat follow-ups, a severe contracted socket was seen (Figure 5).
PMC4010639_02