Scleral abscesses and ectasia caused by Pseudomonas aeruginosa

A 76-year-old woman had signs of endophthalmitis the third day after she underwent uneventful cataract surgery. Intravitreous antibiotics were given, but the eye was unresponsive to the therapy, and, two days later, a small scleral abscess was noted that was not connected to the cornea. Pars plana vitrectomy and appropriate antibiotic therapy were successfully used, and, eventually, the retina regained useful visual acuity. A ring of multiple scleral abscesses developed that persisted for three months, producing scleral thinning and concentric ectasia of the globe. The cornea was free of ulceration at all times. We are unaware of any published cases of Pseudomonas abscess of the sclera without corneal ulceration or scleral damage.