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endophthalmitis

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Definition
Endophthalmitis is an inflammation inside the eye caused by an infection. It is a serious condition that can lead to permanent loss of vision, or visual impairment.

What is going on in the body?
The condition most commonly follows surgery in the eye or a penetrating wound of the eye. Infection within the eye caused by bacteria commonly occurs within 4 to 5 days of surgery or injury. Inflammation in the eye caused by a virus or fungus may have a more chronic course, so the diagnosis may be delayed.

What are the signs and symptoms of the condition?
The symptoms include:
  • severe eye pain and redness
  • decreased vision, or visual impairment
  • light sensitivity
  • a white collection of fluid in front of the iris, known as hypopyon
What are the causes and risks of the condition?
The main cause of endophthalmitis is bacterial infection in the eye following surgery or trauma to the structures inside the eye. It does not usually occur after superficial injury to the eye such as corneal abrasion. Less frequently, infectious agents may enter the eye from the bloodstream, such as with herpes virus or candida yeast infection.

What can be done to prevent the condition?
This condition may not always be prevented. When a person has had eye surgery or has received an injury to the eye, careful treatment and monitoring may decrease the risk of this type of secondary infection.

How is the condition diagnosed?
Endophthalmitis is suspected in any person who develops sudden pain and extreme redness of an eye following surgery or trauma to an eye. It is confirmed by looking at the eye with a microscope. The doctor will be looking for large numbers of white blood cells in the front chamber of the eye, along with clouding of the cornea.

What are the long-term effects of the condition?
If untreated, the condition will result in permanent damage to the structures in the eye, including the retina. This can progress to a permanent decrease in vision and even blindness.

What are the risks to others?
The bacteria, fungi, or virus that causes this secondary infection may be contagious. A person should practice good hand washing and launder towels and face cloths between uses.

What are the treatments for the condition?
Treatment is based on the underlying cause. If the infection is caused by bacteria, and this is confirmed by cultures in the laboratory, then appropriate antibiotics will be used. This usually involves drops, pills, IV therapy, or a combination of all. Injections of antibiotics may be made directly into the eye. When the cause is viral or fungal, then medications for these agents are given. Again, these could be topical, oral, or IV. Whatever the cause, therapy must be given as soon as possible in order to avoid the devastating consequences of these infections.

What are the side effects of the treatments?
Side effects to the treatment depend on the treatment used. All medications can have side effects including stomach upset, rash, and allergic reaction.

What happens after treatment for the condition?
After treatment, a person will need to watch for any recurrent symptoms and continue the medication as prescribed even if symptoms appear to be gone.

How is the condition monitored?
It is imperative to monitor for any further symptoms. A person should contact the doctor if symptoms of redness, pain, swelling, discharge, or blurred vision appear.

Author: William Stevens, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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