endophtalmitis

Question 1

what is endophthalmitis?

Answer 1

purulent inflammation of the intraocular fluids (vitreous and aqueous), usually due to infection.

Question 2

what are the exogenous causes of endopthalmitis?

Answer 2

• Hematogenous spread → seeding of the vascular choroid by the organism → spread of infection to the retina and vitreous
• Common sources of sepsis: hepatobiliary, endocarditis, urinary tract, lungs, skin

Pathogens

• Klebsiella pneumoniae (liver abscess)
• Staph and streptococci (endocarditis, cellulitis)
• Candida albicans (especially in immunocompromised host)

Question 3

what are the endogenous causes of endopthalmitis?

Answer 3

• Bacillus cereus (post-traumatic)

- Coagulase negative streptococci, Staphylococcus aureus, Propionibacterium acnes (post ocular surgery)

Question 4

what are the symptoms for endopthalmitis?

Answer 4

• Loss of vision (94%) – poor visual prognosis, treatment required immediately
• Red eye (82%)
• Severe pain (74%) – almost 25% do not present with pai

Question 5

what are the signs of endopthalmitis?

Answer 5

Severe visual loss
Conjunctival injection & chemosis
Hazy cornea (79% have hazy media)
Anterior chamber cells & hypopyon (85%)
Vitritis
Areas of choroiditis and retinitis may be seen

Question 6

what are the management of endopthalmitis?

Answer 6

• For endogenous causes, identify source of sepsis and treat
• Antibiotics – intravitreal + topical + systemic (intravenous)
• Vitrectomy – if severe and do not respond to antibiotics alone