Strep pyogenes infection causing rapid onset orbital cellulitis, superior ophthalmic vein thrombosis, and necrotizing scleritis with dehiscence of extraocular muscle following strabismus surgery.

Authors

Michael E Gray, Eniolami Dosunmu, Roxana Y Rivera

Published in

American journal of ophthalmology case reports. Volume 43. Pages 102632. Epub Jul 24, 2026.

Abstract

To report an infrequent but potentially devastating complication following strabismus surgery and its approach to management.
A 5-year-old girl underwent bilateral medial rectus recessions for esotropia. She quickly developed progressive orbital cellulitis that was confirmed on computed tomography along with non-occlusive thrombosis of the superior ophthalmic vein. She was treated with intravenous antibiotics, additional surgery (which found a dehisced medial rectus muscle), and anticoagulation. Cultures grew Streptococcus pyogenes (Group A). Ultimately the patient made a full recovery.
Although orbital cellulitis is a known complication following strabismus surgery, surgeons should be aware of additional secondary complications that can occur and have a low threshold for imaging and repeat surgical intervention.

PMID:
42564727
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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