Post Operative Endophthalmitis

Key history
Key examination
Initial management
Referral

This is a rare but devastating complication of intra-ocular surgery. It is included here as prompt recognition and referral for treatment can save the eye and some vision. If delayed, total loss of vision or even loss of the eye itself is likely. All patients should have been informed of its symptoms and asked to present urgently should they occur. Treatment must be done by an ophthalmologist so is not outlined here.

Key history

• Recent intraocular surgery (e.g. cataract surgery, vitrectomy, trabeculectomy)
• Increasing pain AND/OR lid swelling AND/OR decreasing vision
• Trabeculectomy (pressure lowering surgery for glaucoma) patients can develop this months or even years after surgery)

Key examination

DO

• Visual acuity in both eyes

LOOK FOR

• Unilateral red eye
• Swollen eyelids
• Cloudy cornea
• Hypopyon (a level of pus in the anterior chamber)

Initial management

Discuss with the surgeon who preformed the operation or if not available then with the ophthalmology registrar on call.

Referral = Urgent