Abstract
A patient with past medical history of pseudophakic bullous keratopathy presented with one week of right eye redness. Vision was hand motion (previously 20/800). Slit lamp examination was notable for two epithelial defects with associated infiltrates of the cornea, and inferonasal subconjunctival abscess with associated vascularity. Corneal and conjunctival cultures were obtained, and patient was started on fortified vancomycin and tobramycin drops every hour. On subsequent follow-ups over the next week, the keratitis improved with topical antibiotic therapy. However, the scleral abscess continued to grow despite drainage twice. Cultures grew pan-sensitive Klebsiella pneumoniae and multi-drug resistant Corynebacterium jeikkeium. Due to lack of clinical improvement, and growth of a difficult to treat organism, the decision was made to perform conjunctival and scleral debridement, with Rose-Bengal Photodynamic Therapy, and scleral reinforcement with amniotic membrane grafts. Intraoperatively, after debridement there was found to be severe scleral thinning with uveal show. On post-operative follow-up, there was clinical improvement. Abscess recurred once requiring subconjunctival vancomycin. On day 45 (post-operative week 5), there was complete resolution of the infection.
Presentation Date: 09/25/2025
Issue Date: 02/27/2026
