This patient is currently in prison, living in non-salubrious conditions and lacking access to high quality healthcare. Status post phakectomy and intraocular lens implant, he presented with a severe postoperative orbital infection.

On examination, chemosis prevented a full evaluation of the eye; also, there was edema, erythema, pain, and an increase in the thermal perception of the skin of the eyelids and adjacent malar and frontal region. There was also purulent secretions and painful eye movements.

He was evaluated by an ophthalmologist, giving him an initial diagnosis of endophthalmitis, hospitalization, initiation of broad-spectrum antibiotics, local anti-inflammatory agents, and requested an ultrasound. 

The ultrasound demonstrated the involvement of the sclera, and therefore it was re-diagnosed as a panophthalmitis. In addition, there were sonographic signs of pre- and post-septal orbital cellulitis.