Post-traumatic Endophthalmitis Due to a Retained Intraocular Contact Lens Fragment after Open Globe Injury: Case Report

Purpose: This report describes a case of post-traumatic endophthalmitis caused by a contact lens that entered the eye globe at the time of injury.Case summary: A 22-year-old man presented to the emergency room with ocular pain and vision loss in his right eye after a workplace injury involving a brick fragment.He had been wearing soft contact lenses at the time, but the right lens was missing.Initial slit-lamp examination revealed a 3-mm full-thickness corneal laceration near the limbus, iris defect, hyphema, and traumatic cataract.Orbital computed tomography showed no evidence of an intraocular foreign body.Primary surgical repair and intracameral antibiotic injection were performed, and no foreign body was identified during the procedure.However, during postoperative follow-up, anterior chamber inflammation worsened, and ultrasonography revealed dense vitreous opacity.Pars plana vitrectomy was performed under suspicion of delayed endophthalmitis.Intraoperatively, a retained soft contact lens fragment was discovered in the vitreous and successfully removed.Cultures identified Ochrobactrum anthropi as the causative pathogen.Over three years of follow-up, the patient's best-corrected visual acuity improved to 0.63, with no additional complications.Conclusions: In patients wearing contact lenses, a missing lens combined with a corneal laceration after ocular trauma may indicate the possibility of intraocular lens migration through even a small wound.Therefore, intraocular foreign bodies should not be ruled out solely based on negative imaging findings, and thorough evaluation including pre-and postoperative ultrasonography, as well as early vitrectomy, is warranted to confirm and manage potential intraocular foreign bodies.