Endophthalmitis Flashcards
What are the 3 common causes of post-operative endophthalmitis?
-Cataract surgery (most common)
- intravitreal injections
- patient’s own bacterial flora (e.g., skin, lids, conjunctiva).
What organisms can cause post-operative endophthalmitis?
Staphylococcus, Streptococcus, Gram-negative bacteria, and fungi.
What is the onset period for acute post-operative endophthalmitis?
Within the first week after surgery.
When does chronic post-operative endophthalmitis typically onset?
Around six weeks post-surgery.
Can post-operative endophthalmitis be non-infective? Give examples.
Yes, it can be caused by retention of foreign material (e.g., cotton fibers) or toxic substances.
What are the main causes of post-operative endophthalmitis?
Post-operative procedures, injections, patient’s own bacteria (e.g., from blepharitis), and injuries.
What is a sign of post-operative endophthalmitis related to the eyelids?
Lid edema (swelling).
What conjunctival signs are associated with post-operative endophthalmitis?
Conjunctival chemosis (swelling) and hyperemia (redness).
How does corneal haze present in post-operative endophthalmitis?
The cornea becomes cloudy due to infection or inflammation.
What are AC cells and flare, and why are they important in post-operative endophthalmitis?
AC cells are white blood cells, and flare is protein leakage into the anterior chamber, both indicating intraocular inflammation.
What is hypopyon and why is it significant in post-operative endophthalmitis?
Hypopyon is the accumulation of pus in the anterior chamber, signaling a severe infection.
How is the pupil light reflex affected in post-operative endophthalmitis?
The pupil light reflex may become sluggish or absent due to inflammation.
How does post-operative endophthalmitis affect intraocular pressure (IOP)?
IOP can be normal, raised, or low depending on the severity of the inflammation.
What is vitritis, and how does it impact the view of the fundus in post-operative endophthalmitis?
Vitritis is inflammation of the vitreous body, which may eliminate the red reflex, making it difficult to view the fundus.
What are the primary symptoms of post-operative endophthalmitis?
Visual loss, pain, redness, and photophobia (sensitivity to light).
What is the first step in managing suspected post-operative endophthalmitis?
An A1 emergency referral to an ophthalmologist with no intervention, stressing urgency.
What should be done after referring a patient with suspected post-operative endophthalmitis?
Call the ophthalmology department to inform them the patient is on the way.
What diagnostic procedures are done in the hospital for suspected post-operative endophthalmitis?
Ultrasound scan, anterior chamber tap, and vitreous sample collection.
What treatments are commonly used for post-operative endophthalmitis?
Antibiotics (topical, subconjunctival, intravitreal, systemic), steroids (topical, intravitreal, systemic), and vitrectomy if needed to reduce the bioburden.
What is the prognosis for patients with post-operative endophthalmitis?
Poor prognosis, with 55% of patients having 6/60 vision or worse after treatment.
List the signs of post-operative endophthalmitis.
Lid edema, conjunctival chemosis, hyperemia, corneal haze, AC cells and flare, hypopyon, sluggish/absent pupil light reflex, variable IOP, vitritis.
List the symptoms of post-operative endophthalmitis.
Visual loss, pain, redness, photophobia.
