Endophthalmitis Treatment in Ranchi
Urgent, expert management of severe intraocular infections by Dr. Dibya Prabha — Retina & Vitreous Specialist — at Neurovision Clinic, Ranchi. Rapid care to save your vision.
What is Endophthalmitis?
Endophthalmitis is a severe, sight-threatening infection involving the internal structures of the eye — the vitreous cavity (the gel filling the eye) and/or the aqueous humor (the fluid in the front of the eye). It is a true ophthalmic emergency. The infection can be introduced into the eye from outside (exogenous) — most commonly after eye surgery (postoperative), after an eye injection, or following penetrating eye trauma. Less commonly, it arrives via the bloodstream from an infection elsewhere in the body (endogenous). The most common causative organisms are bacteria (staphylococci, streptococci, gram-negative rods), though fungi can also cause endophthalmitis, especially in immunocompromised patients. Without rapid treatment, endophthalmitis leads to irreversible retinal damage, permanent vision loss, and potentially loss of the eye itself.
Symptoms of Endophthalmitis
- •Severe, rapidly progressive eye pain (often out of proportion to exam findings)
- •Sudden, significant decrease in vision — often described as vision getting darker or more blurred by the hour
- •Intense redness of the eye — diffuse, not just in one area
- •Swollen eyelids and conjunctival swelling (chemosis)
- •Extreme sensitivity to light (photophobia)
- •Hypopyon — a visible white/yellow fluid level in the lower part of the anterior chamber
- •Cloudy or hazy appearance to the cornea or anterior chamber
- •Floaters that appeared suddenly after recent eye surgery or injection
- •Systemic symptoms possible in endogenous cases — fever, malaise
Clinical Observations at Neurovision
Dr. Dibya Prabha at Neurovision manages post-traumatic endophthalmitis from penetrating eye injuries in Jharkhand's agricultural and mining workers — injuries from flying stone chips during mining, thorn penetrations during farming, and metallic foreign bodies from informal welding work without eye protection — that become infected within 24–48 hours.
Standard medical literature states:
Endophthalmitis is a severe intraocular infection classified as exogenous (post-surgical, post-traumatic) or endogenous. It is an ophthalmic emergency requiring intravitreal antibiotics and often vitrectomy.
We perform immediate vitreous tap for culture and Gram stain, administer intravitreal antibiotics (vancomycin + ceftazidime) on presentation, and proceed to vitrectomy within hours rather than days. We counsel workers in Hindi that wearing basic polycarbonate safety glasses costs under Rs. 200 and can prevent a blinding infection.
— Dr. Dibya Prabha
Causes & Risk Factors
- •Postoperative infection — the most common cause, occurring after cataract surgery, vitrectomy, glaucoma surgery, or corneal transplant (acute: within days; delayed: weeks to months)
- •Post-intravitreal injection — infection introduced during anti-VEGF or steroid eye injections (rare, ~1 in 2000-5000 injections)
- •Penetrating eye trauma — especially with retained intraocular foreign body (very high risk)
- •Bloodstream spread (endogenous) — from infections elsewhere: endocarditis, IV drug use, indwelling catheters, liver abscess, UTI, or in immunocompromised patients (diabetes, cancer, transplant, HIV)
- •Filtering bleb infection (blebitis) — late infection after glaucoma filtering surgery
- •Corneal ulcer with perforation — infection extending from cornea into the eye
- •Common organisms: Staphylococcus epidermidis, S. aureus, Streptococcus species, Pseudomonas (especially contact lens related), Bacillus cereus (trauma), Candida (endogenous fungal)
Diagnostic Tests
Immediate Slit-Lamp Examination
Urgent, detailed examination of the anterior chamber and vitreous for signs of infection — cells, flare, hypopyon, vitritis — to rapidly confirm the clinical diagnosis.
Vitreous Tap & Culture
A small sample of vitreous fluid is aspirated and sent for Gram stain, culture, and antibiotic sensitivity testing to identify the causative organism and guide targeted antibiotic therapy.
Treatment Approach
Endophthalmitis treatment at Neurovision Clinic is immediate and aggressive, following established protocols for this vision-threatening emergency:
- Intravitreal Antibiotics
- The cornerstone of treatment. A combination of broad-spectrum antibiotics (typically vancomycin + ceftazidime, with or without an antifungal like amphotericin B or voriconazole if fungal endophthalmitis is suspected) is injected directly into the vitreous cavity to achieve immediate, high intraocular drug concentrations.
- Emergency Vitrectomy
- For severe cases (vision reduced to light perception or worse), surgical removal of the infected vitreous gel (vitrectomy) removes the bacterial/fungal load, clears inflammatory debris and toxins, and allows better antibiotic penetration. Dr. Prabha is trained in this sight-saving emergency surgery.
- Systemic & Topical Antibiotics
- Systemic antibiotics (oral or IV) may be added, especially for endogenous endophthalmitis. Frequent topical antibiotic and steroid eye drops are used to control anterior segment infection and inflammation.
- Close Monitoring & Follow-up
- Patients require frequent follow-up (often daily initially) to monitor treatment response, repeat intravitreal injections if infection is not controlled, and manage complications like retinal detachment or elevated intraocular pressure.
When to See a Doctor
- !IMMEDIATELY — if you have severe eye pain with rapidly decreasing vision and redness, especially after recent eye surgery, eye injection, or eye injury. This is a medical emergency; do not wait.
- !If you notice a white/yellow fluid level in your eye when looking in a mirror
- !If you have had recent eye surgery and develop new floaters, pain, or decreasing vision
- !After any penetrating eye injury — seek emergency eye care even if vision seems okay initially
Frequently Asked Questions
What is endophthalmitis and how serious is it?
Endophthalmitis is a severe infection of the internal structures of the eye, including the vitreous and/or aqueous humor. It is one of the most serious ophthalmic emergencies — it can cause permanent, severe vision loss or blindness within 24-48 hours if not treated promptly. Immediate specialist eye care is critical.
What are the symptoms of endophthalmitis?
Symptoms typically include severe eye pain, rapidly worsening vision, intense eye redness, swollen eyelids, sensitivity to light, and sometimes a hypopyon (white fluid level visible behind the cornea). These symptoms demand immediate, emergency ophthalmology evaluation.
How is endophthalmitis treated at Neurovision Clinic?
Treatment must be rapid and aggressive. Dr. Dibya Prabha performs vitreous tap for culture, intravitreal antibiotic injections (delivering medication directly into the eye), and when necessary, emergency vitrectomy surgery to remove infected vitreous and preserve vision. Systemic antibiotics may also be prescribed.