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Blindness following a diabetic foot infection: a variant to the ‘eye–foot syndrome’?
Authors:K C Yuen  N R Baker  A Reddy  C Edelsten  G Rayman
Institution:Diabetes Centre, Ipswich Hospital NHS Trust, Suffolk, UK.
Abstract:AIMS: The 'eye-foot syndrome' was initially described by Walsh et al. to highlight the important association of foot lesions in patients with diabetic retinopathy. We present a case of a 58-year-old patient with Type 2 diabetes mellitus who developed blindness following endogenous staphylococcal endophthalmitis from an infected foot ulcer. RESULTS: Our case describes the link between the eye and the foot but is somewhat different to the association as described by Walsh et al. Endogenous endophthalmitis is rare with diabetic patients being especially at risk, and we report the first case of endogenous staphylococcal endophthalmitis related to a diabetic foot lesion. CONCLUSIONS: Our case illustrates several important issues in the management of diabetic patients admitted to hospital with infection; the need to thoroughly examine the feet to ascertain any foot lesions and any underlying peripheral vascular disease or peripheral neuropathy, to treat aggressively any infected foot lesions to prevent serious complications of septicaemia and to consider rare conditions like endogenous endophthalmitis in any diabetic patient presenting with acute visual impairment and septicaemia.
Keywords:bacteraemia  endogenous staphylococcal endophthalmitis  eye–foot syndrome  infected foot ulcer  Type 2 diabetes mellitus
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