title: Methylene blue related sterile endophthalmitis.
abstract: To report a case of methylene blue related endophthalmitis. Observational case report. Review of clinical record, photographs. A 60 year old man developed endophthalmitis after methylene blue was accidentally used to stain the anterior capsule during phacoemulsification of cataract. His left visual acuity deteriorated from 6/12 to 6/36 two weeks after the operation. Despite intensive treatment with topical and intravitreal antibiotics, his condition deteriorated. A vitrectomy and silicone oil injection eventually managed to control the progression of the disease and salvage the eye. However the visual outcome remained poor due to corneal decompensation and retinal ischemia. Both vitreous tap and vitreous biopsy were negative for any organism. Methylene blue is extremely toxic to ocular structures and should not be used intraocularly.
authors.affiliation: Department of Ophthalmology, Selayang Hospital, Lebuhraya Kepong-Selayang, 68100 Batu Caves, Selangor, Malaysia. akelim@gmail.com
authors.forename: A K E
authors.initials: AK
authors.lastname: Lim
authors.forename: V
authors.initials: V
authors.lastname: Ulagantheran V
authors.forename: Y C
authors.initials: YC
authors.lastname: Siow
authors.forename: K S
authors.initials: KS
authors.lastname: Lim
mesh_terms: D002387:Cataract Extraction; D004396:Coloring Agents / Q000009:adverse effects*; D009877:Endophthalmitis / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D008751:Methylene Blue / Q000009:adverse effects*; D008875:Middle Aged
chemical_list: D004396:Coloring Agents; D008751:Methylene Blue