Orbital cellulitis following silicone-sponge scleral buckles
A 44-year-old schizophrenic, mentally retarded man presented with a few days of pain and proptosis of his previously operated eye. Seven months earlier, he had undergone vitrectomy and SB procedure for RRD. On presentation, the patient was afebrile with significant ocular movement restriction, with limited duction in all fields of gaze and conjunctival chemosis. Computed tomography (CT) revealed a possible eyelid abscess and an expanded SB. He was treated essentially with intravenous (IV) minocycline and tobramycin. After growth of S. aureus, treatment was changed to cloxacillin. The inflammation improved significantly. However, a significant conjunctival granuloma developed 14 months after initial surgery. He underwent buckle removal, conjunctival granuloma excision, vitrectomy, silicone injection, and cataract extraction. He was followed for 12 more months.