1 CLNICAL IMAGE
A 79-year-old man receiving regular, once-monthly ophthalmologic
treatment for left dacryocystitis had normal cornea on March 10, 2020.
On April 5, he noticed decreasing left visual acuity; however, fear of
contracting coronavirus disease 2019 (COVID-19) led him to cancel his
scheduled appointment on April 7. On May 11, he noticed significant left
visual impairment with severe pain and promptly visited the
ophthalmology clinic. As left corneal perforation was observed, he was
urgently referred to our hospital. His left cornea has melted and was
perforated from the center to the lower part, exposing the intraocular
lens and iris (Figure). Methicillin-sensitive Staphylococcus
aureus (MSSA) was detected in a culture test. Emergency evisceration
was performed. Fluoroquinolone antibacterial eye drops, commonly used as
antibacterial agents, have strong antibacterial activity against
pathogenic bacteria causing various bacterial infections including
MSSA.1,2 If he had attended the scheduled appointment
on April 7 and had received routine ophthalmologic examination and
infection treatment, his visual function would probably have been
preserved.
This case underscores the necessity of maintaining ophthalmologic
consultations during the COVID-19 pandemic.