Endophthalmitis
- Infection of inside of eye
- May be introduced by corneal infection, eye trauma, or eye surgery ("exogenous")
- May be introduced via blood stream from infected internal source ("endogenous")
- Unless treated immediately and vigorously, eye will be destroyed
- Pain—often severe—coming from eye
- Loss of sight
- Red, swollen conjunctiva
- Swollen lids
- Hazy cornea
- Hypopyon (pus at base of anterior chamber)
- Keratitis, anterior uveitis, acute angle-closure glaucoma, scleritis, BUT...
- Keratitis usually manifests as focal cloudiness of corneal surface
- Anterior uveitis does not have hypopyon
- Acute angle-closure glaucoma causes diffusely swollen cornea and eye that is rock hard when indented
- Scleritis usually causes focal redness of conjunctiva
- Refer immediately to ophthalmologist
- Consider this diagnosis in any patient with acute red eye and severe eye pain, recent eye trauma or surgery, or known infection elsewhere
- Management involves aspiration of aqueous and vitreous to determine causative organism and intravitreal instillation of appropriate antibiotics
- Preserving useful vision depends on promptness of treatment and nature of pathogen