Endophthalmitis

This is a case of a patient with post-operative light sensitivity 3 days after cataract extraction in the context of not beginning prednisolone drops. The initial vision was 20/25 with a mild fibrinous reaction on the lens and anterior chamber cell. The differential included post-operative inflammation or early TASS. The patient returned with vision decreased to hand motion, increased AC cell and hypopyon, but predominantly anterior segment inflammation. The decision was made to tap and inject vancomycin, ceftazidime, and dexamethasone. The patient was seen the following day with a slightly increased hypopyon and taken to the operating room for pars plana vitrectomy, capsulectomy, and intravitreal microbials. Vitreous culture showed methicillin sensitive staph aureus. The patient improved clinically over the following 3 weeks back to 20/70 vision. This case demonstrates how to differentiate TASS from endophthalmitis, several key points of the endophthalmitis vitrectomy study, and provides an opportunity to discuss future directions of endophthalmitis prevention and management.

Presentation Date: 08/11/2022

Issue Date: 08/19/2022