Endophthalmitis

What Is Endophthalmitis?

Endophthalmitis is the term used to describe severe inflammation of the tissues inside the eye. The inflammation is typically due to infection by bacteria (eg. Staphylococcus species, Streptococcus species, Gram-negative bacteria) or fungi (eg. Candida, Aspergillus). It is rarely caused by viruses (herpes simplex or herpes zoster) or protozoa (eg. Toxocara, Toxoplasma). Sterile (non-infectious) endophthalmitis can develop as a reaction to lens fragments retained in the eye after cataract surgery or to drugs injected into the eye. 

Symptoms

  • Decreased vision
  • Pain
  • Increasing redness or swelling, especially after eye surgery

The symptoms described above may not necessarily mean that you have endophthalmitis. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.

Causes

Endophthalmitis is a rare complication of eye surgery, eye trauma, and injections into the eye.  It also can occur in the setting of a blood-borne infection.

Risk Factors

  • Eye trauma
  • Eye surgery
  • Intraocular injection
  • Bloodstream infection

Tests and Diagnosis

A complete eye examination is necessary to diagnose endophthalmitis. Additional testing, such as ultrasound, culture of intraocular fluids, and laboratory studies, may also be necessary.

Treatment and Drugs

Treatment may include intraocular and/or oral antibiotics and anti-inflammatory agents, and vitrectomy surgery. Even with the most aggressive treatment, it may be difficult to preserve useful vision in cases of severe infection.

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Reviewed by Mark W. Johnson, M.D.