Overview
Endophthalmitis is an ophthalmic emergency describing sight-threatening inflammation of the aqueous and vitreous humours usually secondary to bacterial or fungal infection. This may occur due to:
- Exogenous – such as surgery, trauma, keratitis etc.
- Endogenous (haematogenous spread) – such as infective endocarditis
Panophthalmitis describes inflammation of all eye tissues.
Presentation
Features of endophthalmitis include:
- Eye pain, redness, decreased visual acuity
- Associated headaches and photophobia may be present
- Signs include lid swelling, hypopyon, chemosis, discharge
- Exogenous bacterial endophthalmitis presents suddenly and progresses quickly and is often seen after eye surgery (such as cataract surgery, often after around ~24-48 hours).
- Endogenous bacterial endophthalmitis may have features of coexisting infections (e.g. infective endocarditis)
Management
If suspected, endophthalmitis requires emergency admission to the hospital. Treatment involves antibiotics (which may be intravitreal or systemic), and depending on severity, a vitrectomy may be necessary. Some people may be given steroids once fungal infection has been ruled out to limit inflammation.
