Endophthalmitis following open-globe injuries

Y. Ahmed, A. M. Schimel, A. Pathengay, M. H. Colyer, H. W. Flynn

Research output: Contribution to journalArticle

91 Scopus citations

Abstract

The incidence of traumatic endophthalmitis may be decreasing due to earlier wound closure and prompt initiation of antibiotics. Risk factors for endophthalmitis include retained intraocular foreign body, rural setting of injury, disruption of the crystalline lens, and a delay in primary wound closure. The microbiology in the post-traumatic setting includes a higher frequency of virulent organisms such as Bacillus species. Recognizing early clinical signs of endophthalmitis, including pain, hypopyon, vitritis, or retinal periphlebitis may prompt early treatment with intravitreal antibiotics. Prophylaxis of endophthalmitis in high-risk open-globe injuries may include systemic broad-spectrum antibiotics, topical antibiotics, and intravitreal antibiotics to cover both Gram-positive and Gram-negative bacteria. For clinically diagnosed post-traumatic endophthalmitis, intravitreal vancomycin, and ceftazidime are routinely used. Concurrent retinal detachment with endophthalmitis can be successfully managed with vitrectomy and use of intravitreal antibiotics along with a long acting gas or silicone oil tamponade. Endophthalmitis is a visually significant complication of open-globe injuries but early wound closure as well as comprehensive prophylactic antibiotic treatment at the time of injury repair may improve visual acuity outcomes.

Original languageEnglish (US)
Pages (from-to)212-217
Number of pages6
JournalEye
Volume26
Issue number2
DOIs
StatePublished - Feb 2012

Keywords

  • antibiotic prophylaxis
  • bacillus
  • endophthalmitis
  • open globe
  • retinal detachment
  • traumatic

ASJC Scopus subject areas

  • Ophthalmology

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  • Cite this

    Ahmed, Y., Schimel, A. M., Pathengay, A., Colyer, M. H., & Flynn, H. W. (2012). Endophthalmitis following open-globe injuries. Eye, 26(2), 212-217. https://doi.org/10.1038/eye.2011.313