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.