Abstract

Patient presented with pain, redness and discharge from the right eye and severe headache for 1 month. Patient is a known diabetic on medication for 6 years. She had underwent left great toe amputation, gluteal abscess drainage and treated with antibiotics over past 3 months
Ocular exam showed right eye lid edema, chemosis, hypopyon, corneal infiltration and dilated pupil with no perception of light and high IOP.
B scan showed moderately reflective dot echoes, highly reflective membranous echoes, retino-choroidal scleral thickening and sub-tenon’s fluid, suggestive of pan-ophthalmitis.
Patient showed poor response to INJ. PIPTAZ and INJ. VANCOMYCIN and hence was posted for evisceration with orbital implant. Vitreous tap showed growth of klebsiella Pneumoniae susceptible only to POLYMYXIN B. On post op day 4 wound gaping with dislocated implant noted due to high intra orbital pressure, caused by orbital cellulitis. After antibiotic course for 2 weeks, patient was symptomatically better.