What Is Endophthalmitis?

Medically Reviewed by Whitney Seltman, OD on February 12, 2024
Written by Jeffrey Weishaupt
3 min read

Endophthalmitis is an uncommon infection of the eyeball. It happens inside the tissues or fluids of the eye due to a bacterial or fungal infection.

Endophthalmitis is a medical emergency with a high risk of making you blind. 

The condition requires prompt diagnosis and treatment from an ophthalmologist. Endophthalmitis can be treated with antibiotics, but severe cases may require surgery.

Endophthalmitis is a bacterial or fungal infection of the eye. It affects the fluids or tissues of your eyeballs, including aqueous humor and vitreous humor. 

Aqueous humor is a fluid present inside the front of the eye. Vitreous humor is the jellylike substance present in the back of the eyeball.

The microorganisms causing this type of infection enter the eye through an injury to the eyeball or during surgery on the eyeball. In rare cases, they can also reach the eye through the bloodstream.

You can identify endophthalmitis when your eye discharges white or yellow liquid. The cornea may also show white cloudiness.

In some cases, endophthalmitis can happen very quickly. But it can also develop slowly and stay for an extended time.

The two main endophthalmitis types and their causes are:

Exogenous Endophthalmitis

This type of endophthalmitis is more common. It is caused by the entry of any infectious object from the outside. The sources of these foreign objects vary. 

Some may come inside the eye from an instrument used in a surgical procedure. Other sources could be any sort of eye injury or puncture wounds to the eye. 

If you had eye surgery, you might feel the endophthalmitis symptoms within a few days. When symptoms appear rapidly, you may have acute endophthalmitis. 

Cataract surgeries are the most common eye procedures, but they rarely lead to endophthalmitis.

In some cases, the symptoms may take more time to appear. This type is called chronic endophthalmitis. It is usually caused by the entry of certain types of bacteria or fungi.

Endogenous Endophthalmitis

This type of endophthalmitis is less common. It is not caused by bacteria or fungus. Instead, it starts with an infection in any part of your body that reaches the eye after some time. 

Source infections can be in the urinary tract or the blood.

Eye infections usually appear within a few days. The most common endophthalmitis symptoms are:

  • Intense eye pain that worsens with time
  • Sudden eye pain after any surgical procedure or an eye injury
  • Redness of the eyes
  • Sensitivity to bright light
  • White or yellow discharge from the eyes
  • Swollen eyelids
  • Puffy eyes
  • Impaired or blurred vision

If you observe any of the endophthalmitis symptoms, visit your ophthalmologist immediately. 

If not treated on time, the infection can get worse quickly.

The ophthalmologist will do multiple tests to diagnose your condition. The first test is to check your eyes and test your vision. They will also ask you about your medical history, recent eye injuries, and any surgical procedure.

If you recently had an eye injury, the doctor may want to do an ultrasound to identify any bacteria remains in your eye. 

To further help in a diagnosis, your doctor might recommend a test called an aqueous/vitreous tap. They will take out fluid from your eyeball with a tiny needle, which is tested in a laboratory. 

The results will show the presence of the infection-causing bacteria. Some doctors may also ask for blood and urine samples.

Injecting antibiotics or antifungal medicines in the eye helps preserve your vision and protect your eyes from further bacterial attacks.

The doctor chooses the antibiotic depending on the type of organism causing the infection. Some doctors also opt for intravenous antibiotics.

People with extremely poor vision are given corticosteroids. If you have severe inflammation and soreness in your eyes, you may also receive a steroid to reduce these symptoms. 

You may receive steroids orally or through an injection into the eye after the antibiotic treatment.

In serious cases, doctors may recommend surgery to remove the infected tissue from the eye. It prevents the infection from getting worse. 

In extreme cases, a surgical procedure called vitrectomy may be needed. In this procedure, the doctor removes the infected vitreous gel from your eye. Then, a medicine is injected to prevent the infection in the future.

You can prevent endophthalmitis with some measures, including:

  • Wearing protective eyewear when carrying out activities that may damage your eyes
  • Cleaning your hands and the dropper before putting eyedrops
  • Following your doctor's post-surgery instructions carefully