Healthy Living – August 22, 2017
Michael Johnson, MD – Eastern Maine Medical Center
Endophthalmitis is a very serious condition involving inflammation (swelling) of the internal parts of the eye. It is most often caused by bacterial or fungal infection or other microorganisms that enter the eye during surgery or a penetrating trauma. Endophthalmitis is a rare but potentially blinding emergency. If not treated right away, it can lead to blindness and loss of the eye itself.

Symptoms of endophthalmitis include:
  • increasing redness
  • swelling around the eye
  • light sensitivity
  • severe pain
  • loss of vision
  • hypopyon (puss in anterior chamber of the eye)
These symptoms may not necessarily mean a patient has endophthalmitis, other eye diseases and conditions can cause these same symptoms. An immediate eye exam is highly recommended if all of these conditions exist, especially if the patient has had a recent eye surgery, injection procedure or trauma to the eye.

Causes of Endophthalmitis
Endophthalmitis is a rare complication of eye surgery – most often, cataract surgery and eye injections. Great caution should be used during any eye surgery or procedure to keep sterility and avoid infection.
Sometimes, fragments of the lens left behind in the eye after cataract surgery can cause a certain type of endophthalmitis. In addition, drugs that are injected into the eye’s vitreous cavity can carry infectious agents – either contained in a tainted medication or through the act of penetrating the eye with a needle.
Penetrating trauma to the eye can also introduce bacteria into the inner cavity of the eye, causing endophthalmitis.

Examination and treatment of endophthalmitis
It is extremely important to have your eye examined shortly after a penetrating eye trauma. To properly diagnose endophthalmitis, a complete eye exam will be needed. Testing, such as lab culturing of the eye’s fluid and b-scan ultrasound may be necessary.

Once Endophthalmitis is diagnosed, treatment is urgent and usually comprised of a mixture of potent oral and intraocular antibiotics and anti-inflammatory drugs and, sometimes, vitrectomy surgery.
In mild cases of endophthalmitis, quick treatment can have very successful results. However, it may be difficult to save an eye’s functional vision in some cases. Even the most aggressive treatments can fail to bring an eye back to its pre-infected state and usefulness. Removal of a blind and painful eye may be necessary in worst cases.

Your eye doctor will recommend follow-up exams until he/she is comfortable that they eye did not sustain a lasting infectious injury.