Postoperative Endophthalmitis

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ICD10 CODE: H44.0

Postoperative endophthalmitis is the severe inflammation involving both the anterior and posterior segments of the eye after intraocular surgery.

Cause

• Perioperative introduction of microbial organisms into the eye, followed by inflammation

Clinical features

• Decreased vision, and permanent loss of vision
• Bacterial endophthalmitis: pain, redness, lid swelling, and decreased visual acuity
• Fungal endophthalmitis: blurred vision, pain, and decreased visual acuity

Investigations

• Vitreal tapping for gram stain
• Culture and sensitivity

Management

Treatment	LOC
It is a medical emergency and treatment should be instituted within an hour of presentation, especially in severe cases Refer to an ophthalmologist immediately Admit patients with severe endophthalmitis and treat aggressively with topical, periocular and where possible intravitreal injections of: Antibiotics: vancomycin or ceftriaxone Atropine to relieve pain	H RR

Prevention

• Apply povidone iodine 5% in the conjunctival sac for a minimum of 3 minutes prior to surgery and 10% povidone iodine painting of the periocular skin