Abstract
This article details a case of culture-proven Enterococcus faecalis endophthalmitis that presented clinically years after trabeculectomy and cataract surgery with three different distinct episodes of fulminant infection with clinically quiescent periods between episodes. During the third episode, the patient underwent vitrectomy with removal of the capsular bag. Electron microscopy of the capsular bag confirmed E. faecalis organisms. This is the fifth reported case of recurrent E. faecalis endophthalmitis and the first to document numerous high magnification electron micrographic characteristics from a surgical specimen. This study suggests that recurrences of this rare form of endophthalmitis may occur months after apparently successful initial clinical therapy. To prevent recurrence, removal of the capsular bag and intraocular lens should be considered in cases of endophthalmitis caused by E. faecalis.