Orbital cellulitis following silicone-sponge scleral buckles
An 85-year-old woman presented with 6 hours of left-eye redness and pain. Twelve years earlier, she had had cataract surgery in her left eye. A few months later, she had RRD in her left eye, which was surgically repaired with SB and radial sponge. She presented with frozen globe, proptosis, ptosis, eyelid swelling, and +2 relative afferent pupillary defect in the left eye. CT revealed exophthalmos, dilatation of the superior ophthalmic vein, and retrobulbar and orbital fat infiltration, but no localized abscess (). She responded well to conservative treatment of IV amoxicillin/clavulanic acid and topical moxifloxacin eye drops. A significant clinical improvement was seen following this treatment. On discharge, her VA was 20/70. Ten months later, she presented with left painful eye and abduction limitation. There was a clinical picture of infected SB and she underwent SB removal. IV ciprofloxacin was initiated. There was a growth of Citrobacter koseri sensitive to the antibiotic. A significant clinical improvement was seen under this treatment. She was followed for the next 24 months, and her last VA was 20/40.