Episode 150: Endophthalmitis
Summary
Hosts Britt Long and Manny Singh discuss endophthalmitis, a vision-threatening intraocular infection. The episode distinguishes between exogenous and endogenous causes, highlighting postoperative and traumatic origins as primary risks. Key diagnostic features include hypopion and vitritis, while management centers on urgent ophthalmology consultation for intravitreal antibiotics. Systemic antimicrobials are added for traumatic, endogenous, or fungal cases, with vitrectomy reserved for severe or refractory disease.
Topics discussed
Introduction to endophthalmitis and vision risks
Exogenous vs. endogenous categories and common causes
Hematogenous spread sources and causative microbes
Incidence rates, prognosis factors, and visual outcomes
Risk factors: patient, operative, and post-traumatic
Clinical presentation and systemic symptoms
Physical exam techniques: slit lamp and alternatives
Key exam findings: hypopion, vitritis, and cell/flare
Diagnostic limitations and importance of vitreous culture
Imaging options: POCUS, CT, and MRI
ED role, referral criteria, and predictors of outcome
Intravitreal antibiotic therapy and systemic adjuncts
Fungal coverage and indications for vitrectomy
Summary of diagnosis and management key points
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