Unilateral bilateral acute iris transillumination-like syndrome after intracameral moxifloxacin injection for intraoperative endophthalmitis prophylaxis

In recent years, the use of intracameral moxifloxacin for intraoperative endophthalmitis prophylaxis has gained wide acceptance. Overall, moxifloxacin has been demonstrated to have excellent ocular safety with minimum toxicity. However, some ocular adverse effects have been postulated to be associated with systemic moxifloxacin use. One such possible association identified in recent years is bilateral acute iris transillumination (BAIT), in which sudden pigment dispersion, variable pupillary abnormalities, and diffuse iris transillumination defects are seen in the absence of known infectious or uveitic processes. Until now, such findings have only been reported in the setting of systemic moxifloxacin exposure and never with topical or local exposure. Herein we present the first known case of a BAIT-like syndrome in a single eye after unilateral intracameral injection of moxifloxacin for endophthalmitis prophylaxis.