J Korean Ophthalmol Soc.  2011 Jun;52(6):734-737. 10.3341/jkos.2011.52.6.734.

Spontaneous Eyeball Rupture in a 94-Year-Old Patient

• Park DI
• Park JS
• Kang HY
• Lew H

• KMID: 2214647
• DOI: http://doi.org/10.3341/jkos.2011.52.6.734

Abstract

PURPOSE
To report a case of spontaneous eye ball rupture without trauma in a 94-year-old patient.
CASE SUMMARY
A 94-year-old female patient diagnosed with cataract in both eyes 20 years was referred to this ophthalmologic department for treatment consultation of a painful left eye with spontaneous bleeding. She has used anti-cataract eye drops and artificial tears three times a day for several years without consulting a doctor. Fifteen days prior to presentation, the patient suffered severe left eyeball pain and headache and was diagnosed with acute angle-closure glaucoma secondary to hypermature cataract. She underwnet eviceration after ocular examination and systemic evaluation. Surgical findings included a thin cornea at the inferior limbus and protruding intraocular tissues. Additionally, the eyeball was filled with a blood clot from a choroidal hemorrhage. Morganella morganii were grown in a bacterial swap culture, and a corneal biopsy revealed suppurative inflammation.
CONCLUSIONS
In old age, a thin corneal limbus due to infection and complicated acute angle-closure glaucoma can cause massive suprachoroidal hemorrhage with spontaneous eyeball rupture.

Keyword

Glaucoma; Morganella morganii; Preservative eyedrops; Spontaneous eyeball rupture; Suprachoroidal hemorrhage

MeSH Terms

Biopsy
Cataract
Choroid Hemorrhage
Cornea
Eye
Female
Glaucoma
Glaucoma, Angle-Closure
Headache
Hemorrhage
Humans
Limbus Corneae
Morganella morganii
Ophthalmic Solutions
Rupture
Ophthalmic Solutions

Figure

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  Figure 1. (A) Ruptured left eye ball with protruded intraocular tissues and conjunctival hemorrhage are noted in the 94-year-old female patient. (B) Axial image of orbital CT shows irregular anterior margin of the left eye ball filled with hemorrhage.

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  Figure 2. Intraoperative findings. (A) Protruding intraocular tissues are noted. (B) The cornea is very thin and perforated along the inferior corneoscleral junction. (C) After removal of intra ocular tissues, the posterior part is intact.

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  Figure 3. (A) Choroidal vessels (arrow) with blood clots, inflammatory cells (arrowhead) surrounding vessel wall are noted (H&E stain, ×200). (B) Corneal biopsy specimen presents diffuse supprative inflammation in the stroma. Stromal infiltrations of many lymphocytes are noted (arrowhead) (H&E stain, ×200).

Reference

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