Endophthalmitis

Endophthalmitis is an inflammation of the internal coats of the eye. It is a possible complication of all intraocular surgeries, particularly cataract surgery, with possible loss of vision and the eye itself. Infectious etiology is the most common and various bacteria and fungi have been isolated as the cause of the endophthalmitis. Other causes include penetrating trauma and retained intraocular foreign bodies.

Signs and symptoms

In cases of endophthalmitis, one usually finds a history of recent intraocular surgery or penetrating ocular trauma. In some cases of metastatic endophthalmitis—particularly in immunocompromised patients or those with diabetes—the spread of infection may have been hematogenous (via the blood-stream).

Endophthalmitis is usually accompanied by severe pain, loss of vision, and redness of the conjunctiva and the underlying episclera. Also present are signs of inflammation of the various coats of the eye. Hypopyon can be present in endophthalmitis and should be looked for on examination by a slit lamp.

An eye exam may be indicated in severe forms of candidiasis. 1-3% of cases of candidal blood infections include endophthalmitis.

Complications

• Panuveitis or Panophthalmitis — Progression to involve all the coats of the eye.^[1]
• Corneal ulcer^[1]
• Orbital cellulitis^[1]
• no light perception vision^[1]

Treatment

The patient needs urgent examination by an ophthalmologist and/or vitreo-retina specialist who will usually decide for urgent intervention to provide intravitreal injection of potent antibiotics and also prepare for an urgent pars plana vitrectomy as needed. Enucleation may be required to remove a blind and painful eye.

References

External links

• Endophthalmitis at eMedicine
• Fungal Endophthalmitis at eMedicine