Endophthalmitis following open globe injury

Abstract

Laceration was associatied with a significantly higher risk of endophthalmitis for open globe injuries. Early primary repair, intraocular tissue prolapse and self-sealing of wounds were independent protective factors against the development of endophthalmitis.

Endophthalmitis following open-globe injuries

“…5,14 The reported incidence rate of endophthalmitis following open-globe injury ranges from 0 to 16.5% (Table 1), with evidence of a general decline over the past 70 years. 4,6,12,[14][15][16][17][18][19][20][21][22][23][24] Prophylactic factors in the setting of trauma include primary wound repair within 24 h, lack of tissue prolapse into wounds and self-sealing wounds. 20 In a report from the American Trauma Registry, the incidence of endophthalmitis did not significantly differ among various types of foreign bodies.…”

“…6,12,[14][15][16][17][18][19][20][21][22][23][24] (2) Delay in wound closure of 424 hFthere is a fourfold increase in the infection rate when there was a delay of 424 h. 6 (3) Injury in a rural settingFthe incidence of endophthalmitis was reported to be higher when penetrating injury occurred in a rural setting, which was attributed to a higher incidence of soil contamination.…”

Post-traumatic endophthalmitis

“…Before instituting antifungal treatment, distinguishing fungal from bacterial post-traumatic endophthalmitis is important because the treatments are different and prophylactic antifungal treatment can be toxic both systemically or locally. [2][3][4] A clinical feature that suggests fungal infection is a delayed onset of inflammation after injury. [2][3][4] Literature search has reported that all post-traumatic cases of fungal endophthalmitis became symptomatic between the first and fifth weeks after injury, with minimal discomfort to the patient.…”

“…[2][3][4] A clinical feature that suggests fungal infection is a delayed onset of inflammation after injury. [2][3][4] Literature search has reported that all post-traumatic cases of fungal endophthalmitis became symptomatic between the first and fifth weeks after injury, with minimal discomfort to the patient. 3,4 In the absence of microbiological diagnosis, clinical signs suggesting infection include slow indolent smouldering intraocular inflammation associated with a relatively quiet eye, which may or may not be associated with the presence of an inflammatory mass in the vitreous or anterior chamber that is described as a 'fungal ball', or white vitreous 'snowball', or 'string of pearls'.…”

“…More often than not, the patients with fungal endophthalmitis may have only minor discomfort. [2][3][4] Similarly, not all clinicians agree with the routine use of intravitreal antibiotics in prophylaxis. 5 In patients with open globe injuries and traumatic endophthalmitis, there is always a risk of associated retinal detachment or choroidal detachment.…”