Endophthalmitis

Background

Causes

  • Cataract surgery
    • Usually within 6 weeks
  • Globe Rupture
    • Penetrating eye trauma more at risk than blunt eye trauma
  • Foreign body
  • Extension of keratitis
  • Hematogenous spread/endogenous (rare)

Clinical Features

Endophthalmitis from retained foreign body

Differential Diagnosis

Unilateral Red Eye

^Emergent diagnoses

^^Critical diagnoses

Evaluation

  • Visual Acuity
  • Inspect of lid, cornea, sclera
  • Slit lamp exam
  • Intraocular pressure
  • Bloodwork (CBC, ESR, ) only if considering endogenous endophthalmitis
  • Ultrasound to look for alternative diagnosis

Management

  • Emergent ophtho consult (for gram stain/culture and definitive treatment of intravitreal antibiotics)
  • Systemic antibiotics for endogenous endophthalmitis (rare cause)
    • Systemic antibiotics for other etiologies is controversial
    • Antibiotic prophylaxis in Globe Rupture reduces incidence of endophthalmitis to <1%
    • tetanus, if indicated

Disposition

  • Admit

See Also

References