Pediatric posttraumatic endophthalmitis

To identify the etiology, pars plana vitrectomy results, culture results, and visual outcome of endophthalmitis in the pediatric age group.

Fifteen eyes of 15 consecutive pediatric patients who were treated and followed up for endophthalmitis between July 2011 and December 2012 were included in this study. Combined pars plana vitrectomy and intravitreal norvancomycin plus ceftazidime injection was performed on all 15 eyes. The vitreous samples were obtained by a standard pars plana vitrectomy. The specimens were sent to microbiology facility for gram staining, culturing, and sensitivity testing.

The mean age of the patients was 5.3 ± 2.8 years (3–10 years). The mean follow-up time was 9.7 ± 1.5 months (7–12 months). Preoperatively, the visual acuities of the patients were as follows: light perception (n = 7), hand movements (n = 4), and counting fingers from 30 cm (n = 1), and these values were not available in three patients (n = 3). Postoperatively, the final best corrected visual acuity was 20/200 or better in six (40 %), counting of fingers in four (26.7 %), light perception to hand movements in two (13.3 %), and no light perception in one (6.7 %), with results being unavailable for two patients. Positive culture results were obtained from ten eyes (66.7 %). A single species was isolated in eight eyes, and multiple organisms were isolated in two eyes.

Penetrating ocular trauma was the most common cause of pediatric endophthalmitis in this consecutive series of endophthalmitis. Staphylococci and Streptococcus species were the most common isolated organisms. Patients with multiple organisms had poor visual recovery. Visual outcomes were poor in this series in spite of vitrectomy being performed immediately on all patients.