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Pronunciations corticosteroid endophthalmitis macula macular degeneration pneumonia retina retinopathy sepsis

Endophthalmitis is infection inside the eye.

• Eye surgery, eye injury, or infection in the bloodstream can cause the infection.
• Severe eye pain, eye redness, and loss of vision may occur.
• Cultures are taken of eye fluids, and antibiotics are given as soon as possible.

Endophthalmitis is uncommon. It is caused by organisms that have entered the eye through a surgical incision or an injury to the eyeball or, less often, have traveled through the bloodstream into the eye. Infection in the bloodstream has many possible causes, such as intravenous drug use, an abscess (a collection of pus), skin ulcers, infections such as pneumonia or sepsis, or surgery anywhere in the body. Infection is usually due to bacteria, but fungi or protozoa may also be responsible. Viruses can also cause extensive eye infections, but these are not usually classified as endophthalmitis.

Symptoms may be severe and include pain, redness in the white of the eye, extreme sensitivity to bright light, and partial or complete loss of vision. The diagnosis is based on the symptoms, an examination of the eye, cultures, and sometimes antibody or DNA testing. Cultures may be taken from the aqueous humor (fluid inside the front of the eye, also called the aqueous) and the vitreous humor (the jellylike substance inside the back part of the eye) to determine which organisms are responsible and which drugs are most active against them.

Endophthalmitis is a medical emergency. Immediate treatment with antibiotics is usually needed if vision is to be preserved. A delay of even a few hours can result in irreversible vision loss in extreme cases. The choice of antibiotic may be adjusted depending on which organism is found to be causing the endophthalmitis. Antibiotics may be injected into the eye and given intravenously or orally. Oral corticosteroids may also be given for a few days following injection of antibiotics into the eye. Surgery may be needed to remove infected tissue from inside the eye, which may improve the chances of stopping the infection.

Last full review/revision November 2008 by Sunir J. Garg, MD