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BACKGROUND: Here we describe the characterization of a protracted Aspergillus versicolor endophthalmitis caused by a corneal microperforation. HISTORY AND SIGNS: A 58-year-old patient noticed blurred vision two weeks after he was hit in the eye by an old cable in a dilapidated house. A traumatic cataract and an intraocular inflammation were diagnosed and treated elsewhere with phacoemulsification and anti-inflammatory drugs. Vitreous samples were sterile. Despite topical steroids visual acuity continued to decrease and the patient presented in Lausanne 6 months later with a visual acuity of counting fingers, major inflammation of the anterior segment and a small corneal scar. Fundus examination revealed massive vitreous inflammation with a voluminous whitish chorioretinal infiltrate temporally. THERAPY AND OUTCOME: Vitrectomy with dissection of a protuberant epiretinal filamentous tissue in the temporal fundus was performed, and Amikacine, Vancomycine and Amphothericine were injected intravitreally. Bacteriological work-up revealed Aspergillus versicolor. Visual acuity improved to 0.2 with topical steroids and oral antifungal drugs. CONCLUSIONS: Corneal microperforations may cause a protracted endophthalmitis due to Aspergillus versicolor, a rare fungus, which is commonly found in insulation materials and cables in dilapidated houses.

Background: We describe the re-emergence of a hidden residual intraocular silicone oil bubble after previous silicone oil removal. History and Signs: A 57-year-old patient underwent vitrectomy with silicone oil for a complicated retinal detachment. Six weeks later silicone oil was removed via the pars plana and phakoemul-sification with lens implantation was performed. Subsequent clinical follow-up showed an attached retina without residual silicone oil bubbles. However, more than 2 years later the patient suffered sudden visual loss. Clinical examination showed a bubble of silicone oil wedged between a remaining layer of anterior vitreous and the capsular bag, reducing central visual acuity. Therapy and Outcome: Complete extraction of the silicone oil bubble was performed via the pars plana. Conclusions: Residual silicone oil bubbles may wedge themselves into vitreous pockets in the ophthalmoscopically invisible regions of the pars plana. Over time these bubbles may migrate into the retrolental space with obstruction of the visual axis.