ABSTRACT
There are few reports of endophthalmitis following strabismus surgery. The estimated incidence ranges from 1:3500 to 1:1850001. Despite its major impact on visual outcome, the relative rarity of the event has made it difficult to study definitively. Both the source of the bacteria and the mode of transmission are unknown. Anecdotal reports have speculated on exogenous or endogenous sources, including normal or transient ocular flora2,3. Numerous studies have evaluated methods to decrease preoperative conjunctival bacterial counts in hope of decreasing the risk of infection after strabismus surgery4-6. Currently most pediatric ophthalmologists directly instill 5% povidone-iodine immediately before surgery, but no method completely sterilizes the conjunctiva in all cases7. Even if the host conjunctiva is a major source of infection, the mode of entry to the intraocular space remains unknown. Parks believes that a postoperative cellulitis or abscess precedes and initiates the endophthalmitis. Others suggest that scleral perforation from needles provides a method of access for bacteria2,3.
