Traumatic endophthalmitis following a crane pecking injury - An unusual mode.
OBJECTIVE
To report a case of beta-hemolytic streptococcal endophthalmitis following crane-pecking injury.


METHODS
A twelve-year-old boy was brought to us by his father with history of crane beak injury in his right eye. On examination, his vision was 6/24 Snellen's acuity. Anterior segment examination showed a full thickness two mm corneo-limbal tear at 1 o'clock with iris prolapse. Pupil showed peaking through the wound with a clear crystalline lens. There was no evidence of hypopyon in the anterior chamber and B-scan ultrasonography showed acoustically clear vitreous with an attached retina. Left eye was within normal limits. Primary corneo-limbal tear repair was performed within 24 hours from the time of presentation. Intra-operatively, the corneal surgeon noted turbid aqueous with minimal hypopyon. In view of clinical suspicion of infection, an intravitreal tap for culture was taken during the primary repair, and prophylactic intravitreal antibiotics were given. The culture report showed beta-hemolytic streptococci. Pars plana vitrectomy with intravitreal antibiotics was performed after 2 days as serial ultrasound scans showed appearance and worsening of endophthalmitis. A month after the surgery, his best corrected visual acuity improved to 6/12.


CONCLUSIONS
Ocular injuries resulting from bird pecking are very rare. We treated a case of full thickness corneo-limbal tear with endophthalmitis caused by beta-hemolytic streptococci following a crane-pecking injury. We recommend that injecting intravitreal antibiotics along with primary globe repair in case of severe/contaminated injuries and early pars plana core-vitrectomy would result in better outcome like in our case.
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Prabu
P
Baskaran
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Seema
S
Ramakrishnan
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Pankaja
P
Dhoble
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Joseph
J
Gubert
beta-hemolytic streptococci; crane pecking injury; traumatic endophthalmitis