Metastatic Carcinoma Simulating a Postoperative Endophthalmitis

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Abstract
AN ENDOPHTHALMITIS with hypopyon occurring one month after an uncomplicated intracapsular cataract extraction suggests a fungal infection. In the following case the typical features of a postoperative mycotic endophthalmitis were produced by an unsuspected metastatic neoplasm. Report of a Case Clinical History. —A seemingly healthy 69-year-old white man had noted decreased vision. Ocular examination revealed bilateral cataracts that reduced his vision in each eye to 20/60. On successive weeks intracapsular cataract extractions were done. There were no complications and the eyes were healing nicely until one month postoperatively when the right eye suddenly developed a hypopyon. The fundus reflex was lost, confirming the clinical impression of an endophthalmitis. In spite of topical and systemic steroid therapy and antibiotics, the condition of the right eye deteriorated, and three months following surgery it was becoming phthisical. The vision in the asymptomatic left eye was correctable to 20/20. At about this time the

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