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An 85-year-old patient presented with painful, sudden loss of unilateral vision. Misdiagnosed with endogenous endophthalmitis, he was offered evisceration after no response to antimicrobial therapy. The anterior chamber was opaque with hypopyon-like deposits and oozed liquefied lens material due to a neglected cataract whose lens had burst. After completing an urgent challenging cataract extraction, the patient regained his vision.