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Endophthalmitis Prevention, Diagnostic Procedures and Treatment

Xhevat Lumi, Goran Petrovski, Biljana Vasileva and Angela Thaler

Endophthalmitis is a severe inflammation of the inner eye's structures, caused by an exogenous or endogenous infection with microorganisms which can multiply rapidly. It occurs most frequently after intraocular surgery. Moreover, it can also be a consequence of a penetrant eye injury or a hematogenous dissemination of microorganisms. The most common pathogens of this inflammation are bacteria, next to fungi and less frequently parasites. The occurrence, severity and clinical presentation of endophthalmitis depend on the way of infection, the number and virulence of pathogenic bacteria, as well as the patient's immunity state. The type of endophthalmitis can suggest the possible causative agent. Furthermore, it can help determine therapeutic approach or antibiotics to choose. The more virulent are the causative agents, the early the symptoms and signs of endophthalmitis appear. Such types of endophthalmitis have a bad course and poor prognosis concerning visual function. In these cases the red fundus reflex is lost quite at the beginning of the disease. Patients treated with prompt vitrectomy and intravitreal injections of antibiotics have statistically better visual outcomes and less likelihood of severe visual loss.