A Case of Pseudomonas Orbital Cellulitis Following Glaucoma Device ImplantationGoldfarb, Jeremy, MD*; Jivraj, Imran, MD, FRCSC*; Yan, David, MD, FRCSC*,†; DeAngelis, Dan, MD, FRCSC*,†Journal of Glaucoma: January 2019 - Volume 28 - Issue 1 - p e14–e16 doi: 10.1097/IJG.0000000000001095 Online Articles: Case Report/Small Case Series Buy SDC Abstract Author InformationAuthors Article MetricsMetrics Purpose: Orbital cellulitis is a rare complication of aqueous tube shunt surgery. Nine cases have been described in the literature, though the microbiologic etiology is rarely reported. Management with intravenous antibiotics and/or explantation has been described. Methods: This is a case report and literature review. Case: A 64-year-old woman developed pain, periorbital swelling, limited extraocular motility, proptosis, and conjunctival injection 3 days following implantation of an Ahmed Glaucoma Valve. Computed tomography of the orbits with contrast showed soft tissue fat stranding consistent with orbital inflammation. Initial medical management with topical and intravenous ceftriaxone and vancomycin was unsuccessful. Surgical removal of the implant was performed and intraoperative cultures demonstrated florid Pseudomonas aeruginosa growth. Antibiotic coverage was changed to Piperacillin-Tazobactam for 3 days, with eventual resolution of her orbital symptoms. Conclusions: We report the first case of orbital cellulitis after implantation of a glaucoma device associated with P. aeruginosa. Failure of intravenous and topical antibiotics led to explantation of the valve and targeted intravenous antibiotic therapy with subsequent clinical improvement. *Department of Ophthalmology and Vision Sciences, University of Toronto †Mount Sinai Hospital, Toronto, ON, Canada Disclosure: The authors declare no conflict of interest. Reprints: Jeremy Goldfarb, MD, University of Toronto, Toronto, ON M5S2K9, Canada (e-mail: email@example.com). Received July 30, 2018 Accepted September 7, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.