acute endophthalmitis

Acute Endophthalmitis: A Severe Eye Infection

Acute endophthalmitis is a severe and potentially sight-threatening condition characterized by the inflammation of the interior of the eye, particularly the vitreous and aqueous humor. It typically occurs within hours to days following an eye surgery or trauma.

**Symptoms of Acute Endophthalmit

Acute Endophthalmitis Signs and Symptoms

Acute endophthalmitis is a medical emergency that requires prompt attention to prevent permanent vision loss. The signs and symptoms of this condition can be severe and include:

• Severe eye pain: This is often the first symptom of acute endophthalmitis, and it can be excruciating [1].
• Redness in the white of the eye: The affected eye may become red, swollen, and inflamed, which can be a sign of infection [2].
• Loss of vision: As the infection progresses, vision can deteriorate rapidly, making it difficult to see or even causing blindness [3].
• Yellow or white discharge from the eye: A thick, yellow or white discharge may appear on or inside the eyelid, which

Diagnostic Tests for Acute Endophthalmitis

Acute endophthalmitis diagnosis involves a combination of thorough eye examination, imaging studies, and microbiological testing.

• Eye Examination: A comprehensive eye examination is essential to identify any signs of inflammation or infection within the eye. This includes checking for symptoms such as pain, redness, swelling, and vision loss.
• Imaging Studies: Imaging tests like ultrasound evaluation can help identify any abnormalities within the eye, such as fluid accumulation or retinal detachment.
• Microbiological Testing: Analysis of intraocular fluids (vitreous and aqueous) is crucial to determine the causative organism. This involves collecting a sample from the eye and sending it for culture and gram stain.

Specific Diagnostic Tests

• Ultrasound Evaluation: This test can help identify any abnormalities within the eye, such as fluid accumulation or retinal detachment.
• Microbiological Characteristics: Analysis of intraocular fluids can help determine the causative organism.
• Obtaining Specimens for Culture: Collecting a sample from the eye and sending it for culture is essential to diagnose acute endophthalmitis.

References

• [6] Evaluation of microbiological diagnostic techniques in postoperative endophthalmitis in the Endophthalmitis Vitrectomy Study.
• [7] Diagnosis of Endophthalmitis · Clinical evaluation · Microbiologic testing (eg, gram stain and culture of aspirates for endogenous endophthalmitis, blood and ...
• [9] The purpose of this study is to investigate the application of polymorphonuclear cell counts and smears in the early diagnosis of infectious endophthalmitis.
• [11] Diagnosis of acute endophthalmitis involves thorough eye examination, imaging studies, and microbiological testing, with treatment typically involving urgent intravitreal antibiotics and possible vitrectomy.

Treatment Options for Acute Endophthalmitis

Acute endophthalmitis requires immediate treatment to prevent vision loss and other complications. The primary goal of treatment is to eliminate the infection and reduce inflammation in the eye.

• Intravitreal Antibiotics: Intravitreal injections of antibiotics, such as vancomycin or ceftazidime, are often used to treat acute endophthalmitis [6]. These medications are directly injected into the vitreous humor, the clear gel-like substance that fills the center of the eye.
• Systemic Antibiotics: Systemic antibiotics, such as fluconazole or voriconazole, may also be prescribed to treat acute endophthalmitis [3]. These medications are taken orally and can help to eliminate the infection from the bloodstream.
• Amphotericin-B: In some cases, amphotericin-B may be used to treat fungal endophthalmitis [5]. This medication is typically administered intravenously and can help to reduce inflammation in the eye.
• Adjunctive Systemic Therapy: Adjunctive systemic therapy, which involves administering antibiotics systemically for 48 hours, may also be recommended [4].

Important Considerations

It's essential to note that treatment for acute endophthalmitis should only be administered by a qualified healthcare professional, such as an ophthalmologist or an infectious disease specialist. The most important component of treatment is the intravitreal injection of antibiotics, along with vitrectomy in severe cases [8].

References

[3] Jun 19, 2023 — In general, a systemic azole (eg fluconazole or voriconazole) is recommended. [4] by N Niyadurupola · 2018 · Cited by 3 — Consider adjunctive systemic therapy, with the same antibiotics as those used intravitreally, for 48 hours. [5] Jun 1, 2016 — The ophthalmologist should consider administering intravenous amphotericin-B (0.7-1.0 mg/kg daily), with or without flucytosine (100 mg/kg daily ... [6] Oct 16, 2023 — The drugs recommended for use in acute postoperative endophthalmitis are discussed in Medication

Differential Diagnosis of Acute Endophthalmitis

Acute endophthalmitis is a severe and potentially sight-threatening condition that requires prompt diagnosis and treatment. The differential diagnosis of acute endophthalmitis involves considering various conditions that can present with similar symptoms.

Causes of Acute Endophthalmitis:

• Infectious Agents: Bacterial, fungal, or viral infections can cause endophthalmitis. Common causes include:
  • Staphylococcus aureus [1]
  • Streptococcus pneumoniae [9]
  • Pseudomonas aeruginosa [10]
  • Candida albicans [7]
  • Herpes simplex virus [6, 13]
• Non-Infectious Causes: Other conditions can mimic endophthalmitis, including:
  • Non-infectious uveitis (Behçet syndrome, idiopathic sarcoidosis) [6]
  • Toxic anterior segment syndrome (TASS) [8]
  • Retained lens fragments after cataract surgery [4, 12]

Key Diagnostic Features:

• Clinical Presentation: Patients with acute endophthalmitis typically present with sudden onset of symptoms, including:
  • Severe eye pain
  • Vision loss
  • Redness and swelling of the eye
• Imaging Findings: Imaging studies (e.g., ultrasound, CT scans) can help confirm the diagnosis by showing signs of intraocular inflammation and infection.

Important Considerations:

• Prompt Diagnosis: Acute endophthalmitis requires prompt diagnosis and treatment to prevent permanent vision loss.
• Differential Centrifugation: This technique can be used to identify causative microorganisms in intraocular fluid specimens [14].
• Vitreous Aspiration: Vitreous aspiration may be performed to identify the causative organism and guide treatment [11].

References:

[1] Context result 1 [4] Context result 12 [6] Context results 6, 13 [7] Context result 7 [8] Context result 8 [9] Context result 9 [10] Context result 10 [11] Context result 11 [12] Context result 12 [13] Context result 13 [14] Context result 14