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Endophthalmitis, Postoperative: Differential Diagnoses & Workup
Updated: Nov 6, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Rebound inflammation/iridocyclitis
Retained lens fragments
Complicated primary surgery
Workup
Laboratory Studies
- Most clinicians obtain vitreous and aqueous samples for microbiologic identification of the offending organism.11
Imaging Studies
B-scan (ultrasound): Determine whether there is vitreous involvement of the inflammation. It is also important to note the presence of retinal and choroidal detachment, which is important in the management and prognosis.10,11,20
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Differential Diagnoses & Workup: Endophthalmitis, Postoperative |
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References
Endophthalmitis Vitrectomy Study Group. Microbiologic factors and visual outcome in the endophthalmitis vitrectomy study. Am J Ophthalmol. Dec 1996;122(6):830-46. [Medline].
Gibb AP, Fleck BW, Kempton-Smith L. A cluster of deep bacterial infections following eye surgery associated with construction dust. J Hosp Infect. Jun 2006;63(2):197-200. [Medline].
Cruciani M, Malena M, Amalfitano G, et al. Molecular epidemiology in a cluster of cases of postoperative Pseudomonas aeruginosa endophthalmitis. Clin Infect Dis. Feb 1998;26(2):330-3. [Medline].
Eifrig CW, Flynn HW Jr, Scott IU, et al. Acute-onset postoperative endophthalmitis: review of incidence and visual outcomes (1995-2001). Ophthalmic Surg Lasers. Sep-Oct 2002;33(5):373-8. [Medline].
Taban M, Behrens A, Newcomb RL, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. May 2005;123(5):613-20. [Medline].
West ES, Behrens A, McDonnell PJ, et al. The incidence of endophthalmitis after cataract surgery among the U.S. Medicare population increased between 1994 and 2001. Ophthalmology. Aug 2005;112(8):1388-94. [Medline].
Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. Jun 2007;33(6):978-88. [Medline].
Lundström M, Wejde G, Stenevi U, et al. Endophthalmitis after cataract surgery: a nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology. May 2007;114(5):866-70. [Medline].
Ng JQ, Morlet N, Pearman JW, et al. Management and outcomes of postoperative endophthalmitis since the endophthalmitis vitrectomy study: the Endophthalmitis Population Study of Western Australia (EPSWA)'s fifth report. Ophthalmology. Jul 2005;112(7):1199-206. [Medline].
Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch Ophthalmol. Dec 1995;113(12):1479-96. [Medline].
Lemley CA, Han DP. Endophthalmitis: a review of current evaluation and management. Retina. Jul-Aug 2007;27(6):662-80. [Medline].
Lalwani GA, Flynn HW Jr, Scott IU, et al. Acute-onset endophthalmitis after clear corneal cataract surgery (1996-2005). Clinical features, causative organisms, and visual acuity outcomes. Ophthalmology. Mar 2008;115(3):473-6. [Medline].
Mandelbaum S, Meisler DM. Postoperative chronic microbial endophthalmitis. Int Ophthalmol Clin. Winter 1993;33(1):71-9. [Medline].
Clark WL, Kaiser PK, Flynn HW Jr, et al. Treatment strategies and visual acuity outcomes in chronic postoperative Propionibacterium acnes endophthalmitis. Ophthalmology. Sep 1999;106(9):1665-70. [Medline]. [Full Text].
Fang YT, Chien LN, Ng YY, et al. Association of hospital and surgeon operation volume with the incidence of postoperative endophthalmitis: Taiwan experience. Eye. Aug 2006;20(8):900-7. [Medline].
Maxwell DP Jr, Diamond JG, May DR. Surgical wound defects associated with endophthalmitis. Ophthalmic Surg. Mar 1994;25(3):157-61. [Medline].
Kunimoto DY, Kaiser RS. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. Dec 2007;114(12):2133-7. [Medline].
Johnson MW, Doft BH, Kelsey SF, et al. The Endophthalmitis Vitrectomy Study. Relationship between clinical presentation and microbiologic spectrum. Ophthalmology. Feb 1997;104(2):261-72. [Medline].
Busbee BG, Recchia FM, Kaiser R, et al. Bleb-associated endophthalmitis: clinical characteristics and visual outcomes. Ophthalmology. Aug 2004;111(8):1495-503; discussion 1503. [Medline].
Doft BH, Kelsey SF, Wisniewski SR. Additional procedures after the initial vitrectomy or tap-biopsy in the Endophthalmitis Vitrectomy Study. Ophthalmology. Apr 1998;105(4):707-16. [Medline].
Park SS, Vallar RV, Hong CH, et al. Intravitreal dexamethasone effect on intravitreal vancomycin elimination in endophthalmitis. Arch Ophthalmol. Aug 1999;117(8):1058-62. [Medline].
Brick DC. Risk management lessons from a review of 168 cataract surgery claims. Surv Ophthalmol. Jan-Feb 1999;43(4):356-60. [Medline].
Further Reading
Keywords
postoperative endophthalmitis, eye infection, vitritis, hypopyon, bacterial infection
Differential Diagnoses & Workup: Endophthalmitis, Postoperative