Endophthalmitis

What is endophthalmitis?

Endophthalmitis is a severe inflammation and infection inside the eye, most often caused by bacteria or fungi. It is a medical emergency that can lead to permanent vision loss if not treated promptly. Endophthalmitis most commonly occurs after eye surgery, eye injections, or penetrating eye injuries, but can also result from infections spreading through the bloodstream.

Causes and risk factors

• Post-surgical: Most commonly after cataract surgery or other intraocular procedures.
• Post-injection: Following intravitreal injections for retinal diseases.
• Trauma: Penetrating injuries that introduce bacteria or fungi into the eye.
• Endogenous: Spread of infection from another part of the body through the bloodstream (more common in immunocompromised patients).
• Other risk factors: Diabetes, immunosuppression, poor wound healing, and inadequate sterile technique during procedures.

Symptoms

• Sudden decrease in vision
• Eye pain or discomfort
• Redness of the eye
• Swelling of the eyelids
• Sensitivity to light (photophobia)
• Pus or discharge from the eye
• Floaters or hazy vision

Diagnosis

Diagnosis involves a prompt and thorough eye examination and may include:

• Visual acuity testing: To assess the level of vision loss.
• Slit-lamp examination: To evaluate inflammation in the front of the eye.
• Dilated retinal exam: To assess the back of the eye for infection.
• Ultrasound: If the view to the back of the eye is blocked by infection or debris.
• Sampling of eye fluid: Aqueous or vitreous tap for laboratory analysis to identify the causative organism.

Treatment options

Immediate treatment is critical and may include:

• Intravitreal antibiotics or antifungals: Direct injection of medication into the eye to control infection.
• Vitrectomy surgery: Removal of infected vitreous gel, especially in severe cases.
• Systemic antibiotics or antifungals: Oral or intravenous medications for severe or endogenous cases.
• Topical medications: To reduce inflammation and prevent further infection.

Prognosis and ongoing care

• Early diagnosis and treatment are essential for the best possible visual outcome.
• Some patients may recover good vision, but severe cases can result in permanent vision loss or even loss of the eye.
• Ongoing follow-up is necessary to monitor for complications such as retinal detachment, glaucoma, or recurrent infection.
• Preventive measures, such as proper sterile technique during procedures, are important to reduce risk.

Our approach

We provide rapid assessment, advanced diagnostic testing, and immediate treatment for endophthalmitis. Our priority is to control infection, preserve vision, and support your recovery with comprehensive follow-up care.

Patient Resources

• American Academy of Ophthalmology (AAO) – Endophthalmitis
• American Society of Retina Specialists (ASRS) – Endophthalmitis

If you have additional questions or need support, please contact our office. We are here to help you every step of the way.

Frequently Asked Questions