Post-Strabismus Surgery Endophthalmitis With Subretinal Abscess and Frosted-Branch Angiitis in a Child

Purpose: To report a rare case of post-strabismus surgery endophthalmitis complicated by subretinal abscess, frosted branch angiitis, and delayed rhegmatogenous retinal detachment, with a favorable visual outcome. Methods: A 9-year-old female developed methicillin-sensitive Staphylococcus aureus (MSSA) endophthalmitis following bilateral medial rectus recession, complicated by subretinal abscess, frosted-branch angiitis, and orbital extension. She underwent emergent pars plana vitrectomy (PPV) with infected suture removal, serial intravitreal vancomycin and ceftazidime, and systemic antibiotics. A superonasal rhegmatogenous retinal detachment developed at 3.5 weeks and was repaired with a second PPV and perfluoropropane gas tamponade. Results: Best-corrected visual acuity at 4-month follow-up was 20/25. Good postoperative eye alignment was maintained. Conclusions: Aggressive intervention, including early PPV, operative source control, and systemic antibiotic therapy can achieve meaningful visual recovery in pediatric post-strabismus endophthalmitis despite a severe initial presentation.