Woman presents at emergency department with ‘blueberry eye’

A case of ‘blueberry eye’ is a reminder for clinicians to ensure patients receive proper follow up care, BMJ Case Reports authors highlight.

Clinicians describe how a 51-year-old woman reported to the ophthalmology emergency room with severe pain and light sensitivity in her left eye. She was unable to close her eyelid.

Closer examination revealed a severe conjunctival infection, and a thin, protruding cornea.

“The protruded lesion had a typical blueberry-like external appearance, due to the iris plugging the perforated ulcer,” the authors observed.

The patients best corrected visual acuity was reduced to hand movement in the left eye and 20/40 in the right eye.

Before presenting at the emergency department, the patient was diagnosed with fungal keratitis following trauma but did not comply with topical antifungal treatment.

Clinicians performed a sclerokeratoplasty using a 14mm corneal graft, as well as iridectomy and lensectomy. The corneal graft remained clear at the patient’s four week follow up and her left eye’s best corrected visual acuity improved to 20/100.

The authors noted that the case is a reminder for eye care professionals to ensure compliance with prescribed drugs to prevent the deterioration of infective keratitis.

“Patients at a high risk of ocular surface infections post trauma should be encouraged to attend a regular follow-up at short intervals of time,” they highlighted.

Image credit: BMJ Case Reports 2018