A 61-year-old lady reported with swelling and redness of left eye. The patient was a diagnosed case of multiple myeloma based on anaemia, neutropaenia and bone pain and confirmed with serum electrophpresis 2 years back, had completed three cycles of chaemotherapy with melphalan, dexamethasone and bortezomib and uncontrolled diabetes mellitus (HbA 1 C: 12.7) on insulin of 8 years duration and hypothyroidism presented with a four day history of rapid onset loss of vision, pain and redness of the left eye. There was no history of injury or entry of a foreign body. She also complained of pain and swelling in left arm and inability to move it. General examination revealed a pulse of 78/ min, BP 140/80mm Hg and left arm cellulitis. Ocular examination showed visual acuity of 6/36 in right eye and no perception of light in left eye. Anterior segment of the right eye showed a clear cornea, briskly reacting pupil and an immature cataract, whereas in the left eye, ductions were restricted in all directions, lids were edematous, conjunctiva was congested and chemosed, and showed total corneal sloughing [Table/ Fig-1]. Fundus was normal in the right eye. B scan of the left eye revealed 9X5mm serous choroidal detachment in the temporal aspect of the globe and confirmed panophthalmitis and ruled out uveal plasmacytomas. Blood investigations revealed Haemoglobin 11g%, a total count of 8,800/mm 3 , platelets of 1.6 lac and an ESR 99/hr. Differential count was suggestive of neutrophilia with toxic granules.She was started on intravenous Clindamycin and Metronidazole. Ultrasound of the wrist joint showed only soft tissue swelling ruling out septic arthritis. As the patient did not consent evisceration at this stage, surgery was postponed. The next day the cornea perforated in the central two thirds and showed iris prolapse. Then she underwent evisceration of the left eye. Centre of the cornea showed a 5mm long horizontal perforation with iris prolapse. Lens was found dislocated in the vitreous cavity. Vitreous culture and blood culture did not show any growth. The cellulitis of the arm was controlled. The patient was followed up regularly till 3 months and has been fitted with a prosthesis. DisCussionMultiple myeloma is a malignant proliferation of plasma cells originating from a single clone. Multiple myeloma cripples the human body in many ways, one of them being decreased immunity. Infections occurring spontaneously can increase the morbidity. We report a case of an elderly lady with multiple myeloma on treatment and uncontrolled diabetes, who developed loss of vision, swelling and redness of left eye of 4 days duration. There was no history of injury or entry of a foreign body. She also had left arm cellulitis. Ocular examination revealed visual acuity of 6/36 in right eye and no perception of light in left eye. Anterior segment of the right eye was insignificant while the left eye showed features suggestive of panophthalmitis. B scan revealed choroidal detachment and confirmed panophthalmitis. She underwent evisceration of th...

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