Treatment

• Intravitreal drug administration

  • Bacterial endophthalmitis: empirical intravitreal antibiotic administration in all cases (vancomycin and ceftazidime/amikacin)

  • Mold endophthalmitis or sight-threatening candida endophthalmitis: intravitreal antifungal administration (amphotericin B or voriconazole)

• Systemic antifungal administration (IV fluconazole or voriconazole): early disease due to Candida, all patients with endogenous fungal endophthalmitis

• Pars plana vitrectomy: in patients with sight-threatening endophthalmitis

• Sterile endophthalmitis

  • Mild/early disease: topical steroids

  • Severe inflammation: treat as bacterial endophthalmitis

Early initiation of treatment (within hours) is critical to preserve eyesight.

• Panophthalmitis

• Corneal perforation

• Phthisis bulbi

• Glaucoma

• Permanent loss of vision