Endophthalmitis: Difference between revisions
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==Background== | ==Background== | ||
*Inflammation (usually infectious) of the deep eye structures (aqueous and vitreus chambers) | *Inflammation (usually infectious) of the deep eye structures (aqueous and vitreus chambers) | ||
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*Frequently leads to loss of vision (ocular emergency) | *Frequently leads to loss of vision (ocular emergency) | ||
==Causes== | ===Causes=== | ||
*Cataract surgery | *Cataract surgery | ||
**Usually within 6 weeks | **Usually within 6 weeks | ||
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==Clinical Features== | ==Clinical Features== | ||
[[File:Endophthalmitis_from_retained_foreign_body_2015-02-03_08-16.jpg|thumbnail|Endophthalmitis from retained foreign body]] | |||
*[[Headache]] | *[[Headache]] | ||
*[[Eye pain]] | *[[Eye pain]] | ||
Revision as of 18:56, 20 May 2015
Background
- Inflammation (usually infectious) of the deep eye structures (aqueous and vitreus chambers)
- Frequently leads to loss of vision (ocular emergency)
Causes
- Cataract surgery
- Usually within 6 weeks
- Globe Rupture
- Penetrating eye trauma more at risk than blunt eye trauma
- Foreign body
- Extension of keratitis
- Hematogenous spread/endogenous (rare)
Clinical Features
- Headache
- Eye pain
- Photophobia
- Vision loss
- Ocular discharge
- May also see:
- Conjunctival/scleral injection
- Chemosis
- Hypopyon
- Uveitis
Differential Diagnosis
- Sterile postoperative inflammation
- Red Eye (Unilateral)
- Corneal Abrasion and Foreign Body
- Uveitis
- Vitreous Hemorrhage
Diagnosis
- Visual Acuity
- Inspect of lid, cornea, sclera
- Slit lamp exam
- Intraocular pressure
- After exclusion of Globe Rupture
- Bloodwork (CBC, ESR, ) only if considering endogenous endophthalmitis
- Ultrasound to look for alternative diagnosis
- After exclusion of Globe Rupture
Treatment
- Emergent ophtho consult (for gram stain/culture and definitive treatment of intravitreal antibiotics)
- Systemic antibiotics for endogenous endophthalmitis (rare cause)
- Systemic antibiotics for other etiologies is controversial
- Antibiotic prophylaxis in Globe Rupture reduces incidence of endophthalmitis to <1%
- tetanus, if indicated
Disposition
- Admit
See Also
Eye Algorithm (Main) Globe Rupture