Rabies prophylaxis after an animal attack that caused a ruptured eye and traumatic cataract: a case report

Abstract

Introduction: We report on a patient with an animal bite eye injury, his surgical treatment and proper rabies immunoglobulin administration.

Case presentation: A 33-year-old Turkey hunter was attacked by a bobcat and his injuries included a ruptured globe with corneal laceration, two iris sphincter tears, and a ruptured anterior capsule with a traumatic cataract. Rabies vaccination was started, primary closure of the corneal laceration, an anterior chamber washout and one week later cataract surgery were performed. Three months postoperatively he achieved an uncorrected visual acuity of 20/50 and a best corrected visual acuity of 20/20.

Conclusion: Bobcat attacks on humans are very rare and extremely suspicious for rabies infection of the animal. Ophthalmologists need to be aware of the importance of immediate and appropriate post exposure rabies vaccination. Proper rabies immunoglobulin administration in the setting of globe injuries is challenging and we report on the Center for Disease Control and Prevention recommendations for globe injuries.

Figure 1

Following the bobcat attack the patient had scratches on his right arm and on his face. Rabies immunization was administered around the scratches on his arm.

Figure 2

Slit lamp photograph of the eye, one day after traumatic cataract removal and intraocular lens implantation. The intraocular lens was centered with a best corrected visual acuity of 20/30 and the corneal laceration was closed without any leakage (Seidel negative).