Bilateral acute endophthalmitis associated with munchausen syndrome

Purpose: Endophthalmitis is a potentially blinding intraocular infection that requires urgent intervention. Self-inflicted endophthalmitis is rare, difficult to diagnose, and requires a multidisciplinary approach for management. The purpose is to present a rare case of sequential self-inflicted acute endophthalmitis as a feature of Munchausen syndrome. Methods: This is a case report reviewing imaging and laboratory studies. Results: A 42-year-old female patient developed culture-proven acute endophthalmitis sequentially in both eyes with different bacterial strains. There was clear evidence of selfinflicted corneal puncture tracks in the right eye, and during the course of inpatient psychiatric evaluation, the patient admitted to self-inflicted ocular perforations. Conclusion: Patients with Munchausen syndrome often injure themselves as a method of drawing attention, sympathy, or reassurance. Although ocular injuries due to psychiatric disease are known to occur, intraocular injection as a mode of self-injury is extremely rare. A high index of suspicion must be maintained when the reported history and clinical course are inconsistent.