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Endophthalmitis following open-globe injuries.
Eye (Lond). 2012 Feb; 26(2):212-7.E

Abstract

The incidence of traumatic endophthalmitis may be decreasing due to earlier wound closure and prompt initiation of antibiotics. Risk factors for endophthalmitis include retained intraocular foreign body, rural setting of injury, disruption of the crystalline lens, and a delay in primary wound closure. The microbiology in the post-traumatic setting includes a higher frequency of virulent organisms such as Bacillus species. Recognizing early clinical signs of endophthalmitis, including pain, hypopyon, vitritis, or retinal periphlebitis may prompt early treatment with intravitreal antibiotics. Prophylaxis of endophthalmitis in high-risk open-globe injuries may include systemic broad-spectrum antibiotics, topical antibiotics, and intravitreal antibiotics to cover both Gram-positive and Gram-negative bacteria. For clinically diagnosed post-traumatic endophthalmitis, intravitreal vancomycin, and ceftazidime are routinely used. Concurrent retinal detachment with endophthalmitis can be successfully managed with vitrectomy and use of intravitreal antibiotics along with a long acting gas or silicone oil tamponade. Endophthalmitis is a visually significant complication of open-globe injuries but early wound closure as well as comprehensive prophylactic antibiotic treatment at the time of injury repair may improve visual acuity outcomes.

Authors+Show Affiliations

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL 33136, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22134598

Citation

Ahmed, Y, et al. "Endophthalmitis Following Open-globe Injuries." Eye (London, England), vol. 26, no. 2, 2012, pp. 212-7.
Ahmed Y, Schimel AM, Pathengay A, et al. Endophthalmitis following open-globe injuries. Eye (Lond). 2012;26(2):212-7.
Ahmed, Y., Schimel, A. M., Pathengay, A., Colyer, M. H., & Flynn, H. W. (2012). Endophthalmitis following open-globe injuries. Eye (London, England), 26(2), 212-7. https://doi.org/10.1038/eye.2011.313
Ahmed Y, et al. Endophthalmitis Following Open-globe Injuries. Eye (Lond). 2012;26(2):212-7. PubMed PMID: 22134598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endophthalmitis following open-globe injuries. AU - Ahmed,Y, AU - Schimel,A M, AU - Pathengay,A, AU - Colyer,M H, AU - Flynn,H W,Jr Y1 - 2011/12/02/ PY - 2011/12/3/entrez PY - 2011/12/3/pubmed PY - 2012/3/29/medline SP - 212 EP - 7 JF - Eye (London, England) JO - Eye (Lond) VL - 26 IS - 2 N2 - The incidence of traumatic endophthalmitis may be decreasing due to earlier wound closure and prompt initiation of antibiotics. Risk factors for endophthalmitis include retained intraocular foreign body, rural setting of injury, disruption of the crystalline lens, and a delay in primary wound closure. The microbiology in the post-traumatic setting includes a higher frequency of virulent organisms such as Bacillus species. Recognizing early clinical signs of endophthalmitis, including pain, hypopyon, vitritis, or retinal periphlebitis may prompt early treatment with intravitreal antibiotics. Prophylaxis of endophthalmitis in high-risk open-globe injuries may include systemic broad-spectrum antibiotics, topical antibiotics, and intravitreal antibiotics to cover both Gram-positive and Gram-negative bacteria. For clinically diagnosed post-traumatic endophthalmitis, intravitreal vancomycin, and ceftazidime are routinely used. Concurrent retinal detachment with endophthalmitis can be successfully managed with vitrectomy and use of intravitreal antibiotics along with a long acting gas or silicone oil tamponade. Endophthalmitis is a visually significant complication of open-globe injuries but early wound closure as well as comprehensive prophylactic antibiotic treatment at the time of injury repair may improve visual acuity outcomes. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/22134598/Endophthalmitis_following_open_globe_injuries_ L2 - http://dx.doi.org/10.1038/eye.2011.313 DB - PRIME DP - Unbound Medicine ER -