To report a case of streptoococcus gordonii endophthalmitis after pneumaic retinopexy in a patient with rhegmatogenous retinal detachment.

A 40-year-old man presented with a right eye macula-on retinal detachment extending from 9 to 1 o'clock with one-clock-hour hole at 11 o'clock. After sterilizing with a Betadine solution, 0.6 cc 100% SF₆ gas was injected into the vitreous through the pars plana at 11 o'clock. Two days after the injection, eyeball pain, cell and flare, and pupillary membrane developed. Under the diagnosis of endophthalmitis, vitreous tap and intravitreous vancomycin (1.0 mg/0.1 cc) and ceftazime (2.0 mg/0.1 cc) were administered. However the symptoms and signs worsened, so vitrectomy was performed, and intravitrous injections of silicone, vancomycin and ceftazime were administered. Streptococcus gordonii was identified from the excised vitreous. Visual acuity was light perception due to severe retinal necrosis.

In cases of endophthalmitis after pneumatic retinopexy even with meticulous sterilization, a prompt operation is necessary to prevent extensive retinal damage and visual loss due to the possibility of pathogen growth other than conjunctival normal flora.