When an individual experiences a condition in which their entire eye has swollen due to the effects of a bacteria, virus or fungus, it is known as Endophthalmitis. This disease is very rare; it occurs after 0.1% of eye surgeries and occasionally as a result of bacteria traveling from other parts of the body, such as after a heart surgery or when infected with Candida. Prevention is possible with proper post surgery care and appropriate eye safety practices.
Endophthalmitis is severe and requires immediate attention. This is due to its potential of leaving the patient blind or leaving the eye with significant damage. In this article, we will discuss the symptoms, causes, and treatment options for this inflammation of the eye.
What Is Endophthalmitis?
Endophthalmitis is a situation in which the entire eyeball, both the front and the back portions, has become swollen and inflamed. The eyes can become swollen for a number of reasons, but endophthalmitis refers to a more severe condition that affects the eye in its entirety. Caused by the presence of a bacteria or a fungus, this condition is a very rare complication.
Endophthalmitis has the potential to lead to blindness or devastating damage to eye tissue if not treated correctly and immediately. As a serious eye emergency, an ophthalmologist will treat anyone who has developed this condition with extreme seriousness.
Should an individual suspect the presence of endophthalmitis, they should waste no time in consulting their physician. Treatment requires immediate hospitalization and testing to determine the type of infection or fungus to administer appropriate treatments.
There are two common types of Endophthalmitis:
Endogenous – A very rare occurrence of bacteria such as Staph, Strep, E-coli or chlamydia that have traveled from other areas of the body and infected the eye.
Exogenous – The more common variety which presents after an eye surgery, this type can be either immediate or delayed. It is extremely painful due to extreme swelling.
Symptoms of Endophthalmitis
The most common symptoms of endophthalmitis include:
- A decrease in vision and blurred vision.
- Redness of the eye(s).
- Swollen eyelids.
- Pain in the eye (that worses after the surgery).
- Increased sensitivity to light.
- The appearance of floaters.
Causes of Endophthalmitis
Endophthalmitis is an infection due to the presence of a bacteria, fungus or virus. Those most at risk of developing this condition are predisposed due to the existence of an immunosuppressant condition such as diabetes, kidney failure, cardiac disease, Lupus, AIDs, Cancer, or gastrointestinal issues among others.
The four main endophthalmitis causes include:
Virus and Bacteria
Viruses, bacteria, and fungus are the roots of most endophthalmitis cases. The most common culprits are Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Escherichia coli or the fungus Candida. These can either be present in the eye or have traveled in the bloodstream to the eye.
The most common of endophthalmitis cases occur following surgery of the eyes, especially cataract surgery. Bacteria that remains on the eyelid or in the eye itself quickly becomes infected. Symptoms occur immediately following surgery (withing six weeks of the procedure) or much later (months to even years after). Infections that occur long after a surgery hold a much better prognosis than do their quickly occurring counterparts.
Bacteria that exists in the body can become dislodged during surgery (most often heart surgery) and travel through the body ending up in the eye. This may happen slowly and take a while for the symptoms to appear.
Any time the eye experiences a trauma such as a penetrating injury, there is a possibility that an individual will develop endophthalmitis if the wound is not appropriately cleared of debris. This is especially true when the debris is organic in nature.
Treatment varies widely due to the type of bacteria, and the severity of the infection. The condition often requires hospitalization. This way, doctors and nurses can provide immediate care and are able to monitor the progression of the infection.
Treatment options range from (topical) antibiotics to steroids (intravenous). Doctors usually prescribe the following antibiotics: Gentamicin, Ceftazidime, Vancomycin, or Cefotaxime. Decisions regarding treatment depend largely on the severity of the infection. The best indication of the outcome of treatment for endophthalmitis is the level of vision present before treatment. Doctors can sometimes save the eyesight but it will not always get back to normal.
Individuals who have undergone a cataract or other eye surgery can significantly reduce their risk of infection by simply following all directives ordered after such a surgery. Following surgery, a doctor will have given clear orders on eye care. It is also important to always attend follow-up appointments, as the doctor will check for signs of infection. Specialized tools used by a doctor will alert them to the presence of an infection much quicker than a self-check.
It is also helpful to protect the eyes in ways that will prevent the occurrence of trauma. Always wear protective eyewear when working in hazardous conditions, or when playing a contact sport. While safety glasses are helpful, industrial debris can be especially pesky. It may be best to use eyewear that completely shields the eyes such as goggles or helmets.
Because the symptoms of endophthalmitis do not always present immediately following an eye surgery or traumatic eye injury, if an individual has experienced any of those or has undergone other surgeries like a heart surgery that predispose one to this infection, one should often look for the signs and attend all follow-up visits to their doctor. This infection has the best prognosis when caught and treated early.
Although endophthalmitis is exceedingly rare, the condition is painful and can have severe consequences such as the loss of sight. If treatment is begun early and administered properly, the infection can be adequately treated.
As always, should an individual suspect that they have developed this condition they should seek the assistance of their physician to receive prompt care. Ensuring one follows physician directives and attends post-surgical checkups is the best way to catch endophthalmitis early and treat it before it destroys eyesight completely. Furthermore, practicing proper workplace and athletic safety procedures can lower the risk of a traumatic eye injury that can lead to the condition.