About Endophthalmitis
By Kevin on
Name of the medical condition and other names that it’s been known by
Endophthalmitis
Endophthalmia
Infectious Endophthalmitis, when caused by bacteria or fungi
Panophthalmitis, if the infection spreads to all parts of the eye and surrounding tissues
What is Endophthalmitis?
Endophthalmitis is a serious infection and inflammation inside the eye, affecting the fluids called Aqueous Humor (at the front of the eye) and Vitreous Humor (in the back of the eye). It is considered a medical emergency because it can cause permanent vision loss or even lead to the loss of the eye itself if not treated quickly. The infection is usually caused by bacteria or fungi, which can enter the eye in two main ways:
Exogenous Endophthalmitis: This happens when germs get into the eye from outside sources, such as during surgery (like cataract surgery), through an eye injury, or after injections into the eyeball.
Endogenous Endophthalmitis: This occurs when germs spread to the eye from another part of the body through the bloodstream. For example, people with infections like sepsis, urinary tract infections, or fungal infections may develop this type.
What are its Symptoms?
The symptoms can appear suddenly (acute) or develop slowly over time (chronic). Common signs include:
Severe pain in one or both eyes
Redness and swelling
Blurry or decreased vision
Sensitivity to light
Pus or discharge from the eye
How is it Diagnosed?
Doctors diagnose endophthalmitis using several methods:
A detailed eye exam to check for redness, swelling, and other symptoms.
Taking a sample of fluid from inside the eye (vitreous tap) to identify the bacteria or fungi causing the infection.
Blood tests if systemic infection is suspected.
An ocular ultrasound to check for signs of infection deep inside the eye.
How is it Treated?
Treatment depends on how severe the infection is but may include:
Intravitreal injections (antibiotics or antifungal medications injected directly into the eye).
Corticosteroid injections to reduce inflammation.
Eye drops with antibiotics or antifungal agents.
Surgery called a vitrectomy, where infected fluid is removed from inside the eye.
Systemic antibiotics (oral or intravenous) for infections spreading through the bloodstream.
Trends
In the US, Endophthalmitis occurs in about 0.04% to 0.1% of cases after cataract surgery.
Cases following intravitreal injections are similarly rare, with rates below 0.05%.
Traumatic injuries leading to endophthalmitis occur in approximately 0.9% to 10% of cases, depending on wound severity and location.
Five-Year Trends:
The number of cases has increased slightly due to more frequent use of intravitreal injections for conditions like macular degeneration.
A growing concern involves fungal endophthalmitis linked to systemic infections in immunocompromised patients.
While overall rates remain low, continued increases in surgeries and injections may lead to a slight rise in cases over the next five years. Improved surgical techniques and infection prevention measures are expected to limit this growth.
History
Endophthalmitis has been recognized for centuries as a complication of trauma or surgery involving the eye. Before modern antibiotics, it often led to blindness. Infections were first better controlled in the mid-20th century with advancements in aseptic surgical techniques and antibiotics. The introduction of intravitreal injection therapies for retinal diseases in recent decades brought new challenges, as these procedures slightly increased infection risks. However, improved sterilization methods have kept rates low. Today, early diagnosis and advanced treatments like vitrectomy allow many patients to preserve their vision.
Endophthalmitis - Sources of Information
For informational purposes only. Consult a medical professional for advice.