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14.7 Endophthalmitis

Table of Contents

It is an infection of the ocular cavity. It is an ophthalmic emergency that can cause blindness that may occur secondary to bacteraemia (endogenous infection) or following penetrating eye injury of surgery

Diagnosis Criteria

  • Loss of vision, may be associated with pain in the affected eye
  • Blood culture should be done to identify the source and how it can be treated (for bacteraemia)
  • In post injury or surgery, culture of specimens of aqueous or vitreous humour should be done

Pharmacological Treatment

Refer immediately to an ophthalmologist for treatment

Endogenous Endophthalmitis

Specialist initiated, vitrectomy often required

A: Ceftriaxone 2g IV once a day for 7 days

Adjust antibiotics according to culture and sensitivity

AND

D: Ceftazidime, 2.25 mg intravitreal, repeat after 16–24 hours

AND

D: Vancomycin 1 mg intravitreal, repeat after 72 hours

Administer using separate tuberculin syringes

Post-Surgical endophthalmitis

Specialist initiated, vitrectomy often required

D: Ceftazidime 2.25 mg intravitreal, repeat after 16 – 24 hours

AND

D: Vancomycin 1 mg intravitreal, repeat after 72 hours Administer using separate tuberculin syringes

In addition, if there is soft tissue involvement or as a prophylaxis after a penetrating injury:

A: Ciprofloxacin (PO) 750mg 12 hourly for 7 days.

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