Delayed-onset Staphylococcus epidermidis endophthalmitis masquerading as chronic anterior uveitis 15 years after cataract surgery – case report

Purpose: To report a case of chronic postoperative endophthalmitis that presented 15 years after cataract surgery. Case report: A 73-year-old man presented with ocular inflammation and blurred vision. He was diagnosed with bilateral chronic uveitis by his previous providers. The patient’s ocular inflammation persisted despite multiple immunosuppressive modalities, both topical and systemic. An infectious etiology was suspected, and an intraocular lens/Soemmering’s ring explanation surgery was performed. Specimens were sent to pathology and microbiology. Results: Pathology and microbiology reports came back positive for staphylococcus epidermidis from both the IOL and the capsular bag. Discussion/Conclusion: To the best of our knowledge this is a rare and unique case of culturally proven Staphylococcus epidermidis postoperative endophthalmitis diagnosed 20 years after the inoculating surgery. This case demonstrates the challenges of managing a severe case of ocular inflammation and the resulting increased intraocular pressure not responding to multiple modalities of topical and systemic immunosuppressive medications.