PMC8496094_01
Extraocular movements 48 h following intravitreal antibiotic injection. Right eye showed important eyelid edema and erythema as well as important conjunctival erythema and chemosis. Extraocular movements were limited and painful in all directions.
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The presentation with painful ophthalmoplegia (Fig. 1) and a right relative afferent pupillary defect led to suspect concomitant orbital cellulitis (not only preseptal), cavernous sinus involvement or apex syndrome.
Right eye 48 h following intravitreal antibiotic injection: conjunctival chemosis and erythema, corneal edema, cataract with fibrin on the anterior capsule, 3-4+ cells in the anterior chamber with a 1.5 mm hypopyon.
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The patient was treated empirically with meropenem 2 g IV every eight hours and PF 1% drops were continued hourly (Fig. 2).