Post Fire Cracker Injury Corneal Perforation with Endophthalmitis in a Child

An 8 years old male presented with rapidly detoriating vision in right eye with pain, redness and watering over a period of four days. He had history of trauma to right eye with fire cracker injury 3 days back on eve of festival “Diwali” in India. Right eye had visual acuity of perception of light (PL) only. On slit lamp examination, he had corneal perforation and hypopyon. Ultrasonography was suggestive of endophthalmitis. The exudates from vitreous and anterior chamber were sent for microbiological testing which showed the organism to be Bacillus cereus. He was treated with repair of corneal perforation with intracameral Vancomycin wash and intravtreal Vancomycin injection. Two days post operatively the hypopyon was cleared with decreased exudates in vitreous. Topical moxifloxacin was continued and second dose of intravitreal Vancomycin was given after 72 hours. After 7 days the symptoms improved with vision of 4/60.