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13.5.1

Endogenous Bacterial Endophthalmitis

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 13, Ophthalmic Conditions.

Clinical Description

  • Originates from sources within the body

Signs and Symptoms

  • Decreased vision, pain and tearing, purulent discharge
  • Conjunctiva injection, hypopyon, corneal oedema, vitritis, reduced fundus view secondary to vitreous inflammation.

Investigations

  • Vitreous tap (microscopy, culture, and sensitivity)

Treatment

  • The choice of agents is dependent on culture and sensitivity results
  • Empirically treat endophthalmitis with systemic antibiotics with Ceftazidime 1g 12 hourly and Vancomycin 1g every 12hrs for 2-3 weeks
  • Isolated endophthalmitis is treated with oral Ciprofloxacin 750mg 12 hourly for 7- 14 days and intravitreal antibiotics as in postoperative endophthalmitis below.

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