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A 72-year-old asplenic man developed an acute early pneumococcal endophthalmitis after a routine endocapsular cataract extraction with poor final visual outcome. It is recognized that splenectomy increases the risk and severity of pneumococcal infections. Our patient had not received pneumococcal vaccination or been prescribed prophylactic antibiotics since his splenectomy or at the time of surgery. Failure of these measures to occur may have affected visual outcome.