Endophthalmitis is a purulent inflammation of the intraocular fluids (vitreous and aqueous) usually due to infection.
Serious intraocular inflammatory disorder resulting from infection of the vitreous cavity Progressive vitritis is the hallmark of any form of endophthalmitis Histologically: massive infiltration of the vitreous cavity with inflammatory cells Types of Endophthalmitis Exogenous Acute Postoperative Chronic Postoperative Traumatic Filtering Bleb-Associated After Intravitreal Injections Endogenous Acute Postoperative Endophthalmitis Refers to infectious endophthalmitis shortly after ocular surgery Most present within 1-2 weeks, usually 3-5 days after the surgery. Initial symptoms: rapidly progressive, including pain, red eye, ocular discharge, and blurring Common signs: decreased visual acuity, lid swelling, conjunctival and corneal edema, anterior chamber cells + fibrin, hypopyon, vitreous inflammation, retinitis, and blunting of red reflex Retinal Periphlebitis – earliest sign Endophthalmitis Vitrectomy Study (EVS)[1]
EVS evaluated only the patients with acute endophthalmitis occuring within 6 weeks of cataract surgery or secondary intraocular lens implantation.
Symptoms 94.3% reported blurred vision 82.1% red eye 74% pain- It is important that almost 25% patients did not have pain. 34.5% swollen lid Signs 85% hypopyon- Fifteen percent patients may not have a hypopyon. 79% hazy media 26% LP vision only
When there is a doubt between post-operative inflammation and endophthalmitis with severe haze in the ocular media, or vitreous opacities clinically the possibility of an infection should be given priority.