Endophthalmitis Phacoanaphylactica and Its Relation to Sympathetic Ophthalmia

It is a matter of common knowledge that some persons suffer more or less severe intraocular inflammation after accidental or surgical traumatization of the crystalline lens. Early observers had considered this reaction to be due to infection, the damaged lens furnishing a good culture medium for bacteria. Schirmer,1however, in 1899 reported a series of such cases in which he had found the aqueous sterile. Lagrange and Lacoste2in 1911 appear to have been the first to suggest that the inflammation in these cases is due to an inherent toxicity of the retained lens substance. These authors reported the occurrence of this complication at 8 of 100 cataract extractions. The "toxic theory" was advanced also by Straub,3who presented clinical and histologic observations and suggested the name endophthalmitis phaco-genetica. It is of interest to note that Straub attempted to immunize one of his patients by subcutaneous injections