Endophthalmitis is a bacterial or fungal infection that affects tissues inside the eye. It can occur following eye surgery or trauma. Without proper treatment, the condition can permanently damage the eye.
Some people will require immediate treatment, which sometimes includes surgery.
This article will discuss what endophthalmitis is, its symptoms, and the treatment options.
According to the American Society of Retina Specialists (ASRS), endophthalmitis occurs when the white of the eye becomes inflamed due to a fungal or bacterial infection.
The inflammation is typically severe and requires immediate treatment to avoid permanent damage.
Endophthalmitis can also cause discharge from the eye and lead to a cloudy layer forming over the cornea. The cornea is usually clear to allow light into the eye.
Endophthalmitis is commonly acute, which means that symptoms occur quickly. However, some cases can be chronic with a long onset and duration of symptoms.
Endophthalmitis is typically the result of an infection that causes the eye to become inflamed.
Different types of bacteria or fungi can cause the infection.
According to the American Academy of Ophthalmology (AAO), the bacteria typically responsible in North America and Europe are Staphylococcus aureus and Streptococcus pneumoniae.
Candida albicans usually cause the fungal infections.
Most cases of endophthalmitis are exogenous, which is where the germs enter the eye from outside of the body. For example, the condition might be the result of eye surgery, trauma, or an infected cornea.
A person who experiences eye trauma is more likely to develop endophthalmitis if:
- the foreign object remains in the eye
- the surgery is delayed for longer than 24 hours
- the trauma occurred in a rural setting
- the lens becomes damaged
Acute endophthalmitis usually occurs within 6 weeks of eye surgery or trauma, but symptoms may take longer to emerge in chronic cases.
Endophthalmitis can also be endogenous, meaning that the condition results from an infection elsewhere in the body.
According to the AAO, roughly 2–8% of endophthalmitis cases are endogenous, with most due to S. aureus or Streptococci bacteria.
Other causes of endogenous endophthalmitis include:
The symptoms of endophthalmitis can include:
- worsening, cloudy vision
- eye pain
- redness and swelling in the eye
- difficulty looking at bright lights
- yellow or white discharge from the eye
These symptoms can occur over time or immediately after eye trauma or surgery.
The AAO state that symptoms typically occur in one eye, but in some cases, they can affect both.
The treatment will depend on the type of infection and whether it is acute or chronic.
A doctor will administer the treatment immediately to avoid permanent damage to the eye.
They may prescribe antibiotics if the cause is bacterial and antifungal medications if it is fungal.
According to a 2013 article in the journal Clinical Microbiology and Infection, systemic antibiotics will not typically be effective in treating the infection. As a result, the doctor will usually inject the drug directly into the eye.
In severe cases, a vitrectomy may be necessary. This procedure is a type of eye surgery that can remove debris from the eye to allow the injection.
A doctor may also prescribe a longer term course of an oral antibiotic or antifungal medication.
Without rapid treatment, endophthalmitis can permanently damage the eye.
The damage can cause partial vision loss or even blindness in severe cases.
The AAO state that people with a compromised immune system may be more likely to develop endogenous endophthalmitis.
Common causes of a weakened immune system include:
- chronic corticosteroid use
- end stage renal disease
- intravenous drug use
- dental procedures
Wearing protective gear during contact sports or at work may help prevent debris from getting into the eye.
According to the ASRS, people in rural settings should take extra care to avoid eye trauma. They note that about 30% of injuries in rural settings can lead to infection, compared with 4–13% in other settings.
As eye surgery is another possible cause of endophthalmitis, if a person undergoes eye surgery, they should follow the doctor’s postoperative instructions carefully.
A doctor will usually check for visible symptoms. For example, they might assess the cornea for clouding. They will also ask about the person’s symptoms and the speed of their onset.
In some cases, a doctor might order a biopsy, which will involve taking a sample of fluid from the eye for analysis.
They might also order an ultrasound to check for debris in the eye.
Anyone who suspects that they have an eye infection should see a doctor right away.
People should look out for symptoms that include vision loss, redness and pain in the eye, and yellow or white discharge.
The ASRS state that the symptoms are more likely to occur after an eye operation or trauma. People in rural settings are at higher risk and should take extra care.
A person’s outlook will depend on the severity, type, and duration of the infection.
An older 2010 article states that regardless of whether the endophthalmitis is exogenous or endogenous, the outlook is often poor. Damage to the eye can be permanent, resulting in long-term vision loss.
However, the condition is rare, and advances in hygiene standards and surgical techniques have led to a decrease in its prevalence and improved the management of the condition.
Endophthalmitis is an infection that causes inflammation inside the eye.
The condition can cause pain, swelling, and vision problems. Without rapid treatment, endophthalmitis can lead to permanent damage.
Anyone who suspects endophthalmitis should see a doctor immediately.
The treatment approach will depend on the condition, but it will usually involve an injection into the eye to treat the inflammation.