Endophthalmitis is a rare condition that affects your eyes. It is a serious problem, which requires immediate medical attention. It can cause severe inflammation inside your eye. The affected eye can lose vision due to the infection. The infection can occur due to surgery or trauma. In most cases, certain types of eye surgery or when your eye gets pierced by any outside object can lead to inflammation. The inflammation occurs inside your eye. It affects the vitreous fluid. You can find the fluid at the center of your eye. So, the inflammation of the gel-like, clear substance can spread to other tissues surrounding the eye. It affects your vision adversely. Therefore, you need to take action immediately to prevent severe and permanent complications.

What Is Endophthalmitis?

You need your eye to see things and reciprocate to your surroundings. But, do you know that eyes are the complex yet sensitive organs? Your eyes contain transparent gelatinous mass, which appears colorless. The mass known as vitreous humor fills the space between your retina and lens. It is mostly surrounded by collagen layers also called a vitreous membrane. The membranes separate the space from the rest of your eye. The vitreous membrane makes four-fifth of the whole eyeball volume. The vitreous humor has a gel-like appearance near the edges while has a fluid-like center. The vitreous humor is essential for a clear vision as it is responsible for providing finer details of the vision. The vitreous humor that occupies 80% of your eyes is composed of two major portions:

Central Portion (Core)
Vitreous and cortical vitreous
The outer portion of vitreous

Endophthalmitis occurs when the vitreous humor gets inflamed. The vitreous firmly attaches to your retina vessels, lens capsule, and macula (the region in the retina providing central vision and finer detail). When you suffer eye trauma or get an infection after cataract surgery, it can affect vitreous humor. Vitreous humor is a clear matrix composed of collagen, water, and hyaluronic acid. The bacteria can trigger infection leading to inflammation. You can suffer from the rare problem when drugs are injected into the eye too.

Symptoms Of Endophthalmitis

Depending on the type of endophthalmitis, you can experience various signs. So, read ahead to know the different symptoms, which accompany the problem.

Postoperative Endophthalmitis

It is the severe inflammation occurring on both anterior and posterior areas of your eye after undergoing eye surgery. In most cases, bacterial infection after intraocular surgery can lead to the condition. The serious problem can result in loss of vision permanently. Therefore, you need to take necessary action immediately. Depending on when you suffer infection, the symptoms vary slightly. So, if you experience infection six weeks or less into your cataract surgery, the signs include:

You can experience a dramatic decrease in your vision (affected eye)
Eye pain that worsens after undergoing surgery
Swollen eyelids
Red-eye

Some people can experience symptoms months or years after the surgery. The late signs are milder compared to the early signs. So, you can experience signs like:

Mild eye pain
Increased sensitivity to light (especially bright lights)
Blurred vision

Post Traumatic Endophthalmitis

As the name suggests, it involves suffering an infection in your anterior as well as the posterior area of the eye after a penetrating eye injury. In most cases, a traumatic open eye injury can trigger devastating complications. Open globe injury can trigger infections. It is particularly higher in the presence of IOFBs (intraocular foreign bodies). The risk of infection rises with the presence of contaminated organic matter. So, people suffering from the problem can experience the following signs:

Swollen eyelids
Red eyes
Eye pain that becomes worse with passing time
Decrease of vision dramatically in the affected eye

Hematogenous Endophthalmitis

It is the problem that affects you when an infection in the remote part of your body affects the eyes. The infection can spread through the bloodstream. It finally settles in your eye. You can develop the symptoms gradually over a period of time. So, you only experience subtle symptoms. The signs you can observe are:

Vision Problems

You can experience a mild decrease in your vision. The problem does not occur overnight. It gradually affects you over a period of a few weeks.

Appearance Of Floaters

You can experience floaters in the field of your vision. It can make it difficult to see properly. Floaters are dark, floating shapes with a semi-transparent appearance. It can obstruct your vision making it difficult to view things clearly.

Causes Of Endophthalmitis

The underlying cause of inflammation in your eye depends on the type of endophthalmitis. There are two types of inflammation, which you can read below:

Exogenous Endophthalmitis

It is the inflammation caused when the infection goes inside your eye through an external source. Exogenous form of inflammation is the most common type observed in patients suffering from the problem. It mostly occurs when you experience cut to your eye during surgery. It can also occur when you suffer from the piercing of the eye by an external body. Both types of cuts or openings make your eye more susceptible to infection. In such cases, the infection travels inside your eyeball.

The type of eye inflammation is observed in patients undergoing specific eye surgeries. Cataract surgery can put you at risk of exogenous eye inflammation. Remember, the eye procedure itself does not lead to the problem. But, when the wound is not closed properly, it puts you at risk of infection. Other than cataract surgery, specific surgeries done within the eyeball can lead to the infection and subsequent inflammation.

Risk Factors Associated With Exogenous Endophthalmitis

Not everyone who undergoes cataract or other eye surgeries are at risk of exogenous inflammation. Only people who experience one of the following can suffer from the problem:

Poor wound healing
Extended surgery time (longer time required to complete the surgery)
Extra loss of fluid behind your eye

Endogenous Endophthalmitis

It refers to the infection that spreads to your eye from any other part of the body. So, you can develop an infection anywhere else but it reaches your eye.

Risk Factors Associated With Endogenous Endophthalmitis

People who suffer from piercing eye trauma can experience the type of inflammation when you experience the following:

The foreign object or piece of the object still remains in your eye (not removed completely)
You ignore to get assistance to repair the cut and wait for more than twenty-four hours to seek help
When you live in a rural setting, putting you at risk of getting soil in the eye
Suffer from damage to the lens

Some people who have undergone certain types of surgery for glaucoma are at risk of developing eye inflammation at any point in their life. For example, patients who have had surgery like glaucoma filtering can experience a life-long risk of developing eye inflammation. Therefore, you need to maintain caution and get the necessary medical help as early as possible to overcome the problem.

Diagnosis Of Endophthalmitis

If you have suffered eye trauma or have undergone eye surgery, then you need to see a doctor specializing in eye health. An ophthalmologist can diagnose the problems in your eye and detect any inflammation. Depending on the symptoms the doctor can confirm the presence of endophthalmitis. So, the following diagnostic techniques can help determine eye inflammation.

Physical Examination

The physical exam is the first test to detect any problems in your vision. Your doctor reviews the symptoms thoroughly to determine any problems. The doctor can ask about your medical history. So, you need to inform your ophthalmologist about recent eye trauma or eye surgery. The ophthalmologist uses an ophthalmoscope for examining both of your eyes. So, the lighted instrument can help look inside your eye and detect any problem.

Eye Ultrasound

It is the test suggested when you endure eye trauma. If your doctor suspects the presence of foreign objects due to the trauma still present in the eyeball, then it is the ideal diagnostic method. So, ultrasound offers a clear picture of the problems in your eyes.

Vitreous Tap

If your doctor suspects an infection in your eye, then a diagnostic test called vitreous tap can provide comprehensive information. It involves taking sample fluid from your eyeball. The sample is sent to the lab for testing. Depending on the test results, your doctor suggests the method to treat the infection.

Treatment Of Endophthalmitis

The treatment for eye inflammation depends on the exact cause of the condition and the state of your vision in the affected eye. It is important to get the treatment as soon as possible. It will increase your chances of preserving and restoring vision. When you get prompt treatment, your symptoms can improve within a day or two. So, based on the underlying cause, your ophthalmologist can suggest the following:

Bacterial Infection

To treat inflammation of eye due to bacterial infection, your doctor suggests the following treatment options:

Intravitreal Antibiotics

The treatment option involves injecting antibiotics directly into your affected eye. Before injecting the antibiotic, your doctor removes some vitreous. It provides the necessary room to inject antibiotics. The antibiotics are placed directly into the eye using a tiny needle. In most cases, your doctor adds corticosteroids to reduce swelling immediately. Only in rare cases, your doctor opts for general antibiotics. So, your ophthalmologist opts for the treatment for less severe infection.

Intravenous Antibiotics

Your doctor injects the antibiotics directly into a vein. It is the ideal treatment prescribed for patients who suffer from severe infections.

Topical Antibiotics

Antibiotics are applied directly to the surface of your affected eye. It can treat wound infection along with inflammation to provide you relief.

Vitrectomy

It is the treatment option for severe cases of eye inflammation and vision loss. It is the best treatment when the patient becomes nearly blind due to endophthalmitis. Your ophthalmologist removes a part of the infected vitreous fluid from the affected eye. The infected fluid is replaced with sterile saline or another compatible liquid.

Fungal Infection

At times fungal infection can trigger inflammation in your eye. So, your doctor suggests injecting antifungal medication into the affected eye directly. Depending on the condition, your doctor can suggest taking the medication intravenously or taking oral antifungal medication.

If thereâ€™s a foreign body in the eye, itâ€™s equally important to remove the object as quickly as possible. Never try to remove an object from your eye by yourself. Instead, seek immediate medical attention.

Symptoms often begin to improve within several days of starting treatment. Eye pain and swollen eyelids tend to improve before the vision gets better.

Avoid Complications From Endophthalmitis Treatment

At times complications can arise due to endophthalmitis treatment. Therefore, your doctor suggests certain guidelines to reduce the complications and improve the success rate of treatment. So, you need to follow the pointers suggested below precisely:

You have to follow the eye care instruction religiously. You need to have proper information on how and when to put the antibiotic in eye ointment or eye drops. Follow the instruction to the T and avoid complications.

If your doctor prescribes an eye path, then you need to place the patch at the right place. At times it becomes difficult to keep the patch in its place. So, you need to tape it to keep it in its place.

You need to keep all the follow-up appointments with your ophthalmologist. It helps your doctor monitor your recovery and detect any complications as soon as possible.

Prevention Of Endophthalmitis

With some simple steps, you can avoid endophthalmitis from affecting your vision and life. You can follow the pointers suggested below to ensure your eye remains safe from any problems.

Avoid Trauma To Your Eyes

In most cases, you can get affected by infection due to eye trauma. You can get injured at your workplace or while playing contact sports. So, people at risk of eye trauma need to protect their eyes from debris or other objects that can fly into your eye and cause damage. Debris like sawing wood or other particles can increase your risk of eye trauma. People participating in contact sports can also suffer from eye trauma. Therefore, you need to use protective eyewear to avoid any damage to the eyes. So, you can use the following to ensure the safety of your eyes and vision:

Helmets
Eye Shields
Goggles

Always follow the safety instructions suggested in the workplace or while playing sports to avoid any problems.

Follow Instructions To Avoid Problems After Surgery

People who have undergone cataract surgery need to maintain caution. You need to follow the instructions provided by your ophthalmologist to reduce the risk of infection. The instruction before the operation and post-operation can prevent any infections.

Infection Preventive Steps During Cataract Surgery

It is also important to follow some guidelines during the surgery. Therefore, you need to find an experienced surgeon who can operate on you without any complications. So, check if your doctor provides you the following during the surgery:

The preparation of your eye before the surgery holds significance. It is the critical step as omitting it can increase your chances of getting an infection. Before the surgery, your doctor needs to treat the eye surface with povidone-iodine (5%). It is used universally before any eye surgery as it reduces the rate of infection.
Poor wound closure can put you at risk of endophthalmitis. Therefore, find a surgeon who can perform the operation with precision. The surgery must leave no room for error.
Your ophthalmologist must provide you with topical antibiotics to reduce the bacterial attack on your eyes. The antibiotics can reduce the periocular bacterial flora, which puts you at risk of inflammation.

Post-Operative Care To Prevent Endophthalmitis

After the surgery, you need to follow the instruction provided by the doctor to prevent any complications. So, you have to adhere to postoperative instruction. It reduces your risk of getting affected by infection or inflammation.

You must refrain from performing any strenuous activity for a few weeks after the surgery. Try to take it slow and avoid any heavy lifting or vigorous exercise.
After the cataract surgery, you must avoid driving. Driving can put a strain on your eyes. Therefore, talk to your ophthalmologist about the time safe to resume driving.
You need to take antibiotics and anti-inflammatory eye drops prescribed by your doctor religiously. Taking it as suggested by your doctor can ensure proper healing without any fear of infection. You can take assistance from your family members or friends to administer the medications properly.
Try to stay away from allergens like dust after your surgery. So, clean and vacuum your house properly before undergoing the surgery. Your eyes can become sensitive to dust and other airborne particles.
Do not rub your eyes as it can lead to developing infections.
You have to avoid swimming or taking baths in hot tubs after your eye surgery.
Try to see your ophthalmologist regularly to check your progress. The follow-up exams can detect any issues and monitor your healing.

Conclusion

Endophthalmitis is a rare yet serious condition that can lead to serious outcomes. So, you need to seek immediate treatment to save your vision. Ignoring the problem can lead to permanent vision loss. Therefore, never take the problem lightly. With proper treatment and care at the right time, you can overcome any risk of vision loss. When you get medical assistance at the right time, you can reverse any adverse effects to your eyes. So, you can safeguard your vision and prevent any agony.

References

https://www.healthline.com/health/endophthalmitis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638360/

https://eyewiki.aao.org/Endophthalmitis

Endophthalmitis: Causes, Symptoms, Diagnosis, And Treatment Options