Intraocular Cilia: An Unusual Cause of Endophthalmitis

1. Livia Teo^1,3,4
2. Khoon Leong Chuah²
3. Clarence Hai Yi Teo²
4. Stephen Charn Beng Teoh^1,3,4

¹The Eye Institute, Tan Tock Seng Hospital, Singapore
²Department of Pathology, Tan Tock Seng Hospital, Singapore
³Singapore National Eye Centre, Singapore
⁴Singapore Eye Research Institute, Singapore

Purpose
We describe two patients who were diagnosed to have endophthalmitis secondary to intraocular foreign bodies, confirmed to be cilia on histological examination.

Method
Retrospective chart review. The patients were identified over a 1 year period and their charts were reviewed for demographic characteristics, clinical presentation and course. Intraoperative specimens of the foreign body were sent to the institute's department of pathology for processing. A brief literature review with the keywords "intraocular", "cilia", and "foreign body" was conducted.

Results : The first case is a 13 year old adolescent with no antecedent history of trauma, who developed endophthalmitis that progressed to panophthalmitis despite treatment. The second case is a 31 year old male who developed endophthalmitis in the setting of an open globe injury. Both patients underwent investigations and received maximal medical therapy before surgical intervention. Intraoperatively, both were found to have intraocular foreign bodies which were confirmed to be cilia on histology.

Conclusion:
Clinical presentation and course of patients with intraocular cilia can be extremely variable. Clinical suspicion of intraocular cilia should be raised in cases of endophthalmitis where investigations are inconclusive and the patient fails to respond to maximal medical therapy. In such instances, there is a role for early surgical intervention to obtain histological samples, and to remove the inciting agent to prevent disease progression.