Local and systemic corticosteroids with cycloplegics are the mainstays of therapy. Endophthalmitis, a severe, acute, diffuse uveitis, results from intraocular infection. The vast majority of cases are exogenous following either trauma or intraocular surgery. Less commonly, infection reaches the eye via the bloodstream, most commonly with systemic surgery or abscesses, recent dental procedures, and IV lines or drug abuse. Classically, the symptoms of pain and decreased vision are severe, as are the signs of intraocular inflammation.
Diagnosis requires a high index of suspicion in a patient with appropriate risk factors.
Initial treatment should include broad-spectrum intraocular and systemic antibiotics. Ultimate treatment should be based on Gram stains, cultures, and sensitivities taken on aqueous and vitreous fluid before starting antibiotic therapy. Intraocular corticosteroids are used in selected cases. Visual prognosis is often poor, even with early and appropriate treatment. All rights reserved.