Postoperative Mycobacterium abscessus nodular conjunctivitis

Non-tuberculous or 'atypical' mycobacteria are unusual causes of ocular or periocular infection. We report a case of postoperative Mycobacterium abscessus infection of the conjunctiva. A 71-year-old gentleman developed nodular conjunctival injection and irritation 6 weeks after cataract surgery. After failure of topical therapy with antibiotics, steroids and lubricants, a biopsy was taken. Histological examination revealed non-caseating granulomas within which were clusters of acid-fast bacilli, subsequently identified as M. abscessus. The patient received a total of 16 weeks of oral antimycobacterial treatment and the conjunctivitis completely resolved. A suspected recurrence was successfully treated with topical ciprofloxacin and at final follow up 15 months later there was no evidence of infection. To the best of our knowledge this is the first report of non-tuberculous mycobacterial infection of the conjunctiva occurring after cataract surgery.