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Endophthalmitis is a rare but severe infection that causes inflammation inside the eye, typically affecting the vitreous (the clear gel filling the eye) and the retina. This condition is a sight-threatening ophthalmic emergency that requires immediate intervention.
read more about endophthalmitis ...The causes are usually exogenous (bacteria or fungi entering from outside the eye) following surgery, trauma, or a penetrating injury. The most common trigger is contamination during or shortly after cataract surgery, allowing pathogens to gain entry into the sterile inner structures of the eye.
Less commonly, the infection can be endogenous, traveling to the eye through the bloodstream from a distant infection site in the body. Regardless of the route, the presence of pathogens rapidly causes massive inflammation and irreversible damage to the sensitive retinal tissue.
Symptoms define an acute, rapidly progressing ocular emergency. Patients experience severe eye pain, extreme redness, swollen eyelids, and a precipitous decline in vision. A visible layer of pus may form in the anterior chamber (hypopyon), which is a characteristic clinical sign of the severe inflammation.
The infection can spread and cause irreversible retinal damage within 24–48 hours, making the timing of diagnosis and treatment critical. The speed of treatment dictates the visual outcome for the patient.
Diagnosis is clinical and confirmed by taking a sample of the vitreous humor (vitreous tap) to identify the infecting organism. Treatment is immediate and aggressive, involving intravitreal antibiotics (medication injected directly into the eye) and often emergency vitrectomy surgery to remove the infected vitreous gel.
The long-term consequences of delayed treatment include permanent vision loss or total blindness in the affected eye, and in extreme cases, the potential need for surgical removal of the eye (enucleation). Rapid treatment is the single most important factor for preserving functional vision.
The infection severely affects ocular structures by causing structural damage. The vitreous gel can become cloudy and pull on the retina, potentially causing a retinal detachment. This damage compounds the loss of vision caused by the initial inflammation and infection.
No, it is a rare complication, but it is the most serious infection of the inner eye.
No, the infection is inside the eye and requires antibiotics injected directly into the vitreous gel.
No, it can occur after trauma or from a bloodstream infection, but post-surgical cases are the most frequent cause.
Seek emergency ophthalmic care if you experience sudden, severe pain and a rapid drop in vision after eye surgery or an injury. Endophthalmitis is a medical emergency; a "vitreous tap" and intravitreal antibiotics must be administered immediately to prevent permanent blindness or loss of the eye.
AAO. Endophthalmitis Management (aao.org). 2024.
StatPearls. Endophthalmitis (ncbi.nlm.nih.gov). 2024.
Cleveland Clinic. Ocular Infections (clevelandclinic.org). 2024.
Review of Optometry. Recognizing Endophthalmitis (reviewofoptometry.com). 2023.