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September 1993

Streptococcus pneumoniae Endophthalmitis Following Strabismus Surgery

Author Affiliations

Houston, Tex

Arch Ophthalmol. 1993;111(9):1170-1171. doi:10.1001/archopht.1993.01090090022010

Endophthalmitis is a rare complication in the repair of strabismus. We report herein a case of endophthalmitis following routine strabismus surgery without a known perforation of the globe.

Report of a Case.  A 10-year-old girl underwent uncomplicated bilateral strabismus surgery. Routine preoperative prophylaxis was performed using povidone-iodine (Betadine) and saline combined in a 50/50 mixture. A limbal approach was used with a scleral tunnel surgical technique. After surgery, the patient began treatment with polymyxin B sulfatebacitracin zinc—neomycin sulfate hydrocortisone (Cortisporin) ophthalmic ointment. On the first postoperative day, the patient was orthophoric with normal postoperative examination findings. During the next several days, the patient began to notice increased tearing and swelling in the right eye. She was referred for evaluation of possible endophthalmitis on the fifth postoperative day. Her medical history was significant for hydrocephalus with a ventriculoperitoneal shunt in place.On initial examination, visual acuity was light perception without pro