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Endophthalmitis

Having eye surgery can be a daunting process and unfortunately recovery does not always go as planned.

Endophthalmitis is one of the potential risks following eye surgeries and is defined as an infection of the tissues or fluids inside the eyeball. The source of the infection is usually external and can occur following eye surgery (such as eye injections or cataract surgery), but can also occur following an eye injury or even an infection that spreads from another part of the body.

The most common symptoms of endophthalmitis are:

• eye pain, which normally increases in severity;
• loss of vision or a decreased or blurred vision;
• Discharge from the eyes such as white or yellow pus;
• Red eyes;
• Swollen eyelids.

Other potential symptoms, depending on the type of endophthalmitis you have, may include sepsis, nausea, vomiting, fever and an inaccurate projection of light in your eyes. It should be noted however that these symptoms are not conclusive of endophthalmitis, and may indicate other conditions.

In my experience, if such symptoms do start, the best option is to obtain advice as soon as possible. If you are suffering with endophthalmitis, and it is left untreated, this can lead to a complete loss of vision. You should contact the Hospital as an emergency as time is of the essence once symptoms have presented. If you have recently had eye surgery you should have been provided with contact details of that ophthalmology department, alternatively you should contact 999. They will then either ask you to attend either your ophthalmology department or your local A&E.

Once there, the ophthalmologist will take a history of any surgery or injury to your eye and will then perform several tests to diagnose your symptoms. The types of assessments will depend on the nature of the surgery or injury, and you may require further scans before a diagnosis can be made.

If the doctor suspects that you have an infection, they will perform a test called an aqueous or vitreous tap in which they remove some fluid out of your eye. The fluid sample is then sent for testing on an emergency basis to check for the presence of an infection.

If a diagnosis of endophthalmitis is then made, treatment is normally an injection of antibiotics or antifungal medicine into the eye. Depending on the type and extent of the infection you may require a steroid, to reduce any swelling and inflammation, or vitrectomy surgery to remove vitreous gel from your eye and to inject the eye with medicine that should treat the infection. Unfortunately, unless endophthalmitis is diagnosed and treated promptly this may result in severe vision loss, even with treatment. Without timely treatment, it may also progress to panophthalmitis, which is a condition that effects all the structures of your eye, and can result in the requirement of the removal of your eye, either partially or completely.

Your visual outcome following the treatment of endophthalmitis can vary depending on a number of factors. This can include the type of endophthalmitis, the type of infection present, your visual acuity at the time you attend for treatment and the time taken to initiate the treatment from the onset of the infection.

We consider that patient education is one of the most valuable elements in obtaining an early diagnosis and treatment. When you attend for any intraocular procedure, you should be advised of the warning signs that may occur following the procedure and provided with details of who to contact if you have any notable symptoms to ensure that you can be assessed at the earliest opportunity.

The development of endophthalmitis, even when due to an infection which enters the eye during or after a surgery, does not necessarily mean that the procedure was negligent. However, if you do believe that there was a failure in your treatment of eye surgery, the aftercare or the treatment of endophthalmitis then please do not hesitate to contact one of the team for some no obligation, no win no fee advice.

For more information contact Sarah Riley in our Clinical Negligence department via email or phone on 01133866685. Alternatively send any question through to Forbes Solicitors via our online Contact Form.

Learn more about our Clinical Negligence department here

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