What is endophthalmitis?

Endophthalmitis is an infection inside the eye. Fortunately, it is rare, but it can cause severe visual loss even with treatment. It is most common following severe eye injuries, eye surgery and intravitreal injections of medications like Avastin, Lucentis, and triamcinolone.

What are the symptoms of endophthalmitis?

The most common symptoms of endophthalmitis are abrupt visual loss, redness and pain. Pain can be variable and is not always present. The symptoms most often begin within a few days of the inciting event. Less commonly, the infection can arise months after eye surgery — typically cataract surgery — and progress slowly. This is known as chronic endophthalmitis and usually causes much milder symptoms than acute (rapid-onset) endophthalmitis.

What causes endophthalmitis, and how is it treated?

Endophthalmitis is typically caused by bacteria, but it can occasionally be caused by a fungus. For bacterial infections, antibiotics are injected into the eye. The most commonly injected antibiotics are vancomycin and ceftazidime. They are usually injected together. This combination of antibiotics is able to effectively treat most bacterial infections inside the eye. For fungal infections, a medication called amphotericin B is often injected into the vitreous.

What is the prognosis for vision with endophthalmitis?

Endophthalmitis after a severe eye injury, known as traumatic endophthalmitis, often causes permanent, severe visual loss. Endophthalmitis following cataract surgery is most often caused by a type of bacterium that fortunately does not usually cause permanent, severe loss of vision if treated promptly. A minority of patients with endophthalmitis after cataract surgery do suffer severe, permanent visual loss. Endophthalmitis after intravitreal injections tends to be caused by a more aggressive type of bacterium and usually results in permanently decreased vision despite aggressive treatment.