Signs and Symptoms of Endophthalmitis | Ophthalmology


What is endophthalmitis?

Endophthalmitis is a bacterial or fungal infection that affects the tissues inside the eye. It occurs after eye surgery or injury. It is usually caused by an infection or microbial invasion of the eye, most often after eye surgery; however, it can be caused by an injury to the open eye or by the spread of infection through the blood-borne pathways from the cornea or other parts of the body. The agents of endophthalmitis are bacteria, followed by fungi and, less frequently, parasites. Without proper treatment, this condition can permanently damage the eye. Some people need immediate treatment, which sometimes involves surgery.

Causes of endophthalmitis

There are two main types of endophthalmitis. One is exogenous endophthalmitis, which means that the infection travels from the external source to the eye. The second is endogenous endophthalmitis, which is an infection that spreads from another part of the body to the eye.

Exogenous endophthalmitis: It is the most common form. It is caused by an incision in the eye or a foreign body that pierces the eye during surgery. Such incisions or openings are likely to spread the infection within the eyeball.

Exogenous endophthalmitis is more common in specific eye surgeries. One is cataract surgery. This is not due to a surgical procedure. Cataract surgery is the most common eye surgery, so the chances of getting endophthalmitis for this surgery are high.

Endophthalmitis is more likely to occur if a person sustains an eye injury:

  • The foreign object is in the eye
  • Surgery is delayed for more than 24 hours.
  • The injury occurred in a rural setting.
  • The lens is damaged

Acute endophthalmitis usually occurs within 6 weeks after eye surgery or injury, but in chronic cases, symptoms take longer to clear up.

Endogenous endophthalmitis: It is the second main type of endophthalmitis. It begins as an infection in another part of the body and spreads to the eye. For example, it can occur with a urinary tract infection or a blood infection.

Other causes of endogenous endophthalmitis include:

  • Urinary tract infections
  • Recreational use of intravenous drugs.
  • Surgical procedures such as endoscopy.
  • Resident catheters

Risk factors

People with a compromised immune system may be more likely to develop endophthalmitis

Common causes of a weakened immune system are:

  • Diabetes
  • Chronic use of corticosteroids
  • The final stage is kidney disease.
  • Intravenous drug use
  • Dental procedures

Symptoms of endophthalmitis

Symptoms occur very quickly after infection. These usually occur within a day or two, or sometimes up to six days after surgery, or with an injury to the eye. features:

  • Eye pain may get worse after surgery or after an eye injury
  • Decrease or loss of vision.
  • Redness and swelling of the eye
  • Eye pus
  • Swollen eyelids
  • It’s hard to see the bright lights
  • Yellow or white discharge from the eye

These symptoms can occur over time or after an eye injury or surgery.

Symptoms, such as six weeks after surgery, can also appear later. These features are mild and include:

  • Blurry vision
  • Mild eye pain
  • Trouble seeing bright lights

If you notice these symptoms, see a doctor immediately. Endophthalmitis is treated quickly, making it less likely to cause severe and persistent vision problems.

Diagnosis of endophthalmitis

The diagnosis of endophthalmitis is initially confirmed by clinical and microbiological cultures. In general, the following samples are taken for diagnostic analysis

  • Aqueous humor pattern
  • Dilute the non-vitreous standard
  • Diluted vitreous pattern

Samples are then submitted for the gram and gyms staining, as well as aerobic, anaerobic, and fungal growth cultures with an antibiotic test. The polymerase chain reaction (PCR) test is much more sensitive than cultures because even if only a few microorganisms are detected, the test result will be provided within a few hours. However, the downside of this investigation is the high probability of sample contamination.

Your doctor, usually an ophthalmologist (who specializes in eye health), will do several things to find out if you have symptoms of endophthalmitis. They look you in the eye and test your vision. They may order an ultrasound to see if there are foreign objects in the eyeball.

If an infection is suspected, your doctor may perform a test called a vitreous puncture. This involves using a small needle to draw some fluid from the eyeball. The fluid will then be tested so your doctor can tell you the best way to treat the infection.

Treatment for endophthalmitis

Treatment depends on the type of infection and whether it is acute or chronic.

The doctor will prescribe treatment immediately to avoid permanent damage to the eye.

Treatment consists of an injection of antibiotics or antifungal medications into the eye. You can also take steroids to reduce inflammation and inflammation caused by infection.

It is important to receive an antibiotic for the eye as soon as possible. Antibiotics are usually put directly into the eye with a small needle. In some cases, corticosteroids can be added to reduce inflammation. Generic antibiotics are given only in very rare and serious cases.

If there is a foreign body in the eye, it is equally important to remove the object as soon as possible. Never try to remove an object yourself from the eye. Instead, seek immediate medical help.

Symptoms begin to improve within a few days of starting treatment. Eye pain and swollen eyelids may improve before vision improves.


Following your doctor’s eye care advice can reduce complications from endophthalmitis treatment. In particular, do you know how and when to apply prescription eye drops or antibiotic eye ointment? If an eye patch is indicated, you also need to know how and where to apply the patch. You may need tape to put the patch on.

Be sure to keep all eye appointments with your doctor.


Use protective eyewear is directed primarily to the reduction of the microbial flora of the eye surface, eyelids, and lashes with proper preparation of the operative field, maintaining its sterility during the procedure and preventing infection until complete epithelialization of the wound has been achieved. When doing things around the house that can hurt your eyes. These include :

  • Goggles
  • Eyeshields
  • Helmets
  • Wear proper safety glasses and gear during contact sports

Follow your doctor’s home care instructions after eye surgery or eye injection. For example, hands should be washed before applying eye drops. Do not allow the bottle of eye drops to touch your eye.


Endophthalmitis is an infection that causes inflammation within the eye.

This condition can cause pain, swelling, and vision problems. Without prompt treatment, endophthalmitis can cause permanent damage.

Anyone who suspects endophthalmitis should see a doctor immediately.

The treatment approach depends on the condition but generally involves an injection into the eye to treat the inflammation.

Departments to consult for this condition

  • Department of Ophthalmology
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