Bacterial Endophthalmitis

Excerpt

Endophthalmitis constitutes a critically severe ocular infection with the potential to precipitate rapid and irreversible vision loss within mere hours or days following the initial presentation of symptoms. The condition is characterized by the infection of the eye's vitreous and/or aqueous humor, predominantly by bacterial or fungal pathogens. In contrast, intraocular infections caused by viral or parasitic pathogens are categorized under uveitis rather than endophthalmitis. The etiology of endophthalmitis is deemed exogenous or endogenous. Exogenous endophthalmitis is more prevalent and results from introducing microorganisms into the eye, either from the ocular surface or from another external source. The condition is further categorized based on specific risk factors, leading to distinct subtypes such as post-cataract surgery, post-traumatic, and bleb-related endophthalmitis. Each category exhibits unique clinical presentations, microbiological profiles, and prognostic implications for visual outcomes, necessitating precise categorization for optimized management and therapeutic strategies. In contrast, endogenous endophthalmitis arises from the hematogenous dissemination of pathogens during episodes of bacteremia or fungemia.

Temporal factors within study parameters influence the frequency of endophthalmitis types. Post the U.S. Food and Drug Administration's (FDA) approval of intravitreal anti-vascular endothelial growth factor (anti-VEGF) medications for neovascular age-related macular degeneration in 2004, a marked increase in the utilization of these and other intravitreal injections was seen. Consequently, some centers have observed that post-injection endophthalmitis cases have surpassed postoperative cases.

If diagnosed and treated promptly with appropriate antibiotics, patients with bacterial endophthalmitis can recover fully and preserve their vision. Given the time-sensitive nature of bacterial endophthalmitis, it is of the utmost importance for clinicians to recognize this ocular disorder and put the patient on the quickest path to recovery.