Endophthalmitis

Endophthalmitis is a serious inflammatory condition affecting the interior of the eye, specifically involving the vitreous and/or aqueous humor cavities. It is most commonly caused by bacterial or fungal infection, though sterile (non-infectious) forms also exist. The condition can be classified as exogenous endophthalmitis, which occurs following ocular surgery (particularly cataract surgery), intravitreal injections, or penetrating eye trauma, or as endogenous endophthalmitis, which results from hematogenous spread of microorganisms from a distant infection site to the eye. Endogenous endophthalmitis is rarer and often associated with immunocompromised states, intravenous drug use, or systemic infections. Key symptoms include rapidly progressive eye pain, decreased visual acuity, redness of the eye (conjunctival injection), swelling of the eyelids, and the presence of hypopyon (a visible layer of white blood cells in the anterior chamber). Patients may also experience photophobia, floaters, and lid edema. Without prompt treatment, endophthalmitis can lead to severe and permanent vision loss or even loss of the eye. Treatment requires urgent intervention and typically involves intravitreal injection of broad-spectrum antibiotics (such as vancomycin and ceftazidime for bacterial cases, or amphotericin B or voriconazole for fungal cases). In severe cases, pars plana vitrectomy — a surgical procedure to remove infected vitreous material — may be necessary. Systemic antibiotics or antifungals may be added depending on the etiology. Topical and sometimes systemic corticosteroids are used as adjunctive therapy to reduce inflammation. The visual prognosis depends heavily on the causative organism, the severity at presentation, and the timeliness of treatment. Early recognition and aggressive management are critical to preserving vision.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Endophthalmitis