Purpose

to describe the clinical pretension,diagnostic challenges, and management outcomes of atypical bacterial biofilm infections in ophthalmic socket and periocular dermal fillers.

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Methods

A retrospective clinical review was conducted on patients with positive (nontuberculous mycobacteria) between 2019 – 2026, or patients received mycobacterial antibiotics coverage excluding Tuberculosis patients. reviewing clinical, radiological, sensitivity, treatment outcome for the included patients.

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Results

twenty-nine patients were identified: twenty-six patients involving anopathlmic sockets, three patients following cosmetic periocular dermal filler injections. all patients initially mistreated for other conditions or standard bacterial infection with delayed treatment between weeks to years. definitive diagnosis was established by mycobacterial culture or histopathology on biopsy. the filler related atypical mycobacterial infection was diagnosed with anti-mycobacterial therapy response. variable clinical responses, the required atreatment was either medical, surgical or both.

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Conclusion

Atypical mycobacterial infections represent an uncommon but highly challenging and trending in oculoplastic practice. Raising clinical suspicion early in cases persistent, chronic or unresponsive to empirical therapy are key to eradicate the infection and reduced the morbidity. heightened clinical awareness is the absolute key to managing this condition.

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Additional Authors

First name	Last name	Base Hospital / Institution
Rawan	Althaqib	king khaled eye specialist hospital and research center
Hamad	alsuliman	king khaled eye specialist hospital and research center
abdullah	almatter	Ophthalmology department, King Saud University
Mashael	Alkhayyal	king khaled eye specialist hospital and research center

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