Isolated extraocular muscle abscess presenting 40 years after squint surgery

Area of Science:

• Ophthalmology
• Infectious Disease

Background:

• Periorbital infections are uncommon sequelae of strabismus (squint) surgery.
• Reported cases typically manifest within a week of surgical intervention.

Observation:

• A 57-year-old male presented with an orbital abscess near the lateral rectus muscle.
• Symptoms included reduced visual acuity and restricted lateral eye movements, initially diagnosed as orbital cellulitis.
• Ultrasound suggested a foreign body, but none was found during surgical exploration.

Findings:

• Surgical findings revealed fibrotic changes indicative of prior squint surgery.
• The patient later confirmed a history of strabismus surgery 40 years prior.
• The orbital abscess was likely caused by a chronic suture granuloma.

Implications:

• This case suggests that orbital abscesses can occur decades after squint surgery.
• Chronic suture granulomas may present as a rare, delayed complication of strabismus procedures.
• Ophthalmologists should consider remote surgical history in atypical orbital infections.