Spontaneous Extrusion of Lens in Fungal Scleral Abscess

Infection is an uncommon cause of scleral inflammation and it heals with appropriate treatment in majority of patients. However, necrosis of scleral tissue occurs in severe microbial infections resulting in abscess rarely. We describe a case of 45- years old female patient who presented with pain, redness in left eye and swelling of left eyelids of four days duration. There was no history of trauma to the eye. Left eye had only perception of light. There were signs of central leucoma and abscess in upper nasal quadrant of sclera in left eye. Patient was started on topical and systemic antibiotics. Eye swab culture did not grow any organisms. The slough excised from the scleral abscess was positive for fungus in Grams stain and potassium hydroxide preparation; and Candida albicans was isolated in the culture. The patient was treated with topical and systemic antifungal drugs. Five days later, scleral perforation was noted with partially transparent lens in the scleral abscess area which was extruded spontaneously due to movement of the eye. After complete healing, the eye became phthisical and blind. This case is reported in view of the rare occurrence of spontaneous extrusion of the lens in a patient with fungal scleral abscess.