GeneHealth - Your precision medicine

Endophthalmitis

Disease Details

Family Health Simplified

Buy Membership

Description: Endophthalmitis is a severe inflammation of the interior of the eye caused by infection, which can lead to vision loss if not promptly treated.
Type: Endophthalmitis is an inflammatory condition of the intraocular cavities, usually caused by infection. It is not a genetic disease and therefore does not have a type of genetic transmission. The condition can be classified as either exogenous, resulting from external contamination (e.g., following eye surgery or trauma), or endogenous, where the infection spreads to the eye from another part of the body.
Signs And Symptoms: Symptoms of endophthalmitis include severe eye pain, vision loss, and intense redness of the conjunctiva. Bacterial endophthalmitis more commonly presents with severe and sudden symptoms whereas fungal causes have a more insidious onset and severity, with 80% of ocular candidiasis (both chorioretinitis and endophthalmitis) being asymptomatic. Hypopyon, or inflammatory cells in the anterior chamber of the eye may be present. In endogenous endophthalmitis systemic signs and symptoms may be present, including fevers, chills, mental status changes, hypotension or other signs of sepsis. 8-20% of endogenous endophthalmitis affect both eyes. In both endogenous and exogenous types of endophthalmitis, approximately 20% of people will experience severe vision loss.
Prognosis: The prognosis for endophthalmitis varies depending on the cause, the time to treatment, and the specific type of organisms involved. Rapid diagnosis and treatment are crucial for better outcomes. Delayed treatment can lead to significant vision loss or even blindness. Intravitreal antibiotics and sometimes surgical intervention such as vitrectomy are standard treatments that can improve the prognosis. Early and aggressive treatment generally results in a better prognosis.
Onset: Endophthalmitis onset can vary, but symptoms typically appear rapidly, often within a few days after surgery, trauma, or an eye injection, with signs such as pain, redness, reduced vision, and swelling. Nan (nanoscale) particles are being researched for targeted drug delivery in treating this condition.
Prevalence: Endophthalmitis is a rare but serious condition. The prevalence varies depending on the cause, such as post-surgical, post-traumatic, or endogenous sources. For post-cataract surgery, the incidence ranges from 0.04% to 0.2%. Post-traumatic endophthalmitis occurs in approximately 3-17% of open globe injuries. Endogenous endophthalmitis is less common and accounts for about 2-15% of all endophthalmitis cases, but exact prevalence can vary by region and population.
Epidemiology: Endophthalmitis is a severe inflammation of the interior of the eye, usually caused by an infection.

**Epidemiology:**
- **Incidence:** Endophthalmitis occurs infrequently, with the incidence depending on the specific scenario. Postoperative endophthalmitis after cataract surgery has an incidence ranging from 0.03% to 0.2%. The incidence following intravitreal injections is approximately 0.02% to 0.05%.
- **Risk Factors:** Major risk factors include recent eye surgery, particularly cataract surgery, penetrating ocular trauma, and systemic infections that can spread to the eye.
- **Demographics:** There is no significant age or sex predilection, though the elderly may be more represented due to the higher prevalence of cataract surgery in that demographic.

"nan" is not applicable in this context.
Intractability: Endophthalmitis, an inflammation of the interior of the eye usually caused by infection, is not inherently intractable. However, its outcome can depend significantly on the promptness and effectiveness of treatment. Immediate medical intervention with antibiotics and sometimes surgical procedures like vitrectomy can lead to successful resolution of the infection and preservation of vision. Delays in treatment or particularly severe infections may lead to more challenging cases and potential vision loss, highlighting the importance of early and appropriate medical care.
Disease Severity: Endophthalmitis is a severe condition. It is an inflammation of the interior of the eye, typically caused by infection. Immediate medical attention is crucial to prevent potential vision loss or blindness.
Healthcare Professionals: Disease Ontology ID - DOID:4692
Pathophysiology: Endophthalmitis is an inflammation of the interior of the eye, typically caused by a bacterial or fungal infection. It can occur after eye surgery, trauma, or from an endogenous source where the infection spreads internally from another part of the body.

**Pathophysiology:**
1. **Introduction of Pathogens:** Bacteria or fungi can enter the eye through surgical procedures, penetrating trauma, or hematogenous spread.
2. **Inflammatory Response:** Once inside, the pathogens multiply, leading to an intense inflammatory response. The immune system responds by sending white blood cells to the eye, causing an accumulation of pus and inflammatory cells.
3. **Tissue Damage:** The inflammation and immune response can cause tissue damage via the release of enzymes and reactive oxygen species, which can affect the retina and other structures within the eye.
4. **Visual Impairment:** As the infection progresses, inflammatory exudates and cellular debris can obstruct vision, potentially leading to decreased vision or even blindness if untreated.

Prompt diagnosis and treatment are critical to prevent severe complications and preserve vision.
Carrier Status: Endophthalmitis is an inflammation of the interior of the eye, usually caused by infection. There is no carrier status associated with endophthalmitis as it is not a hereditary or carrier-based disease. It typically arises from external sources like surgery, trauma, or systemic infections.
Mechanism: Endophthalmitis is an inflammation of the interior of the eye, often caused by infection.

**Mechanism:**
Endophthalmitis can be categorized primarily as exogenous or endogenous.

1. **Exogenous Endophthalmitis**: This is the more common form, typically resulting from external microbial contamination due to surgery (such as cataract surgery), ocular trauma, or intravitreal injections. Pathogens enter the eye and proliferate, leading to inflammation.

2. **Endogenous Endophthalmitis**: This occurs when infectious agents spread to the eye from another part of the body through the bloodstream. Common sources include systemic bacterial infections, fungemia, or even rare cases of parasitic infections.

**Molecular Mechanisms:**
1. **Pathogen Entry and Proliferation**: Microorganisms, predominantly bacteria (e.g., Staphylococcus aureus, Streptococcus species) or fungi, invade the eye's vitreous and aqueous humor. They use various virulence factors to adhere, invade, and evade the immune response.

2. **Innate Immune Response**: The body's first line of defense is the innate immune response, which includes the activation of macrophages, neutrophils, and other immune cells. These cells release cytokines and chemokines (e.g., interleukins, tumor necrosis factor-alpha) that mediate inflammation and recruit additional immune cells to the site.

3. **Inflammatory Cascade**: The infiltration of immune cells and the release of pro-inflammatory mediators lead to further tissue damage within the eye. An overactive immune response can contribute to collateral damage, affecting the retina and other ocular structures.

4. **Cytokine and Chemokine Production**: Infected retinal cells and immune cells produce high levels of cytokines, such as IL-1, IL-6, and TNF-α. These molecules exacerbate inflammation and can lead to further tissue damage and impaired vision.

5. **Tissue Damage**: Enzymes and reactive oxygen species (ROS) released by immune cells in an attempt to eradicate the pathogens also cause tissue damage. The integrity of the blood-retinal barrier may be compromised, leading to increased vascular permeability and edema.

Effective management of endophthalmitis hinges on rapid identification of the causative agent and prompt administration of targeted antimicrobial therapy, often coupled with anti-inflammatory treatments to mitigate the damage caused by the inflammatory response.
Treatment: Urgent medical attention is required if a person has suspected endophthalmitis. Intravitreal injection of antibiotics are indicated in bacterial endophthalmitis. Intravitreal injections of vancomycin (targeted against Gram-positive bacteria) and ceftazidime (targeting Gram-negative bacteria) are routine. Even though antibiotics can have negative impacts on the retina in high concentrations, since visual acuity worsens in 65% of endophthalmitis patients and prognosis gets poorer the longer an infection goes untreated, most medical professionals make the clinical judgment decision that immediate intervention with antibiotics is necessary. Fungal pathogens are treated with intravitreal injections of amphotericin B or voriconazole. Systemic antibiotics or anti-fungals are used in those with endogenous endophthalmitis with associated bactermia or fungemia. People with endophthalmitis may also require an urgent surgery (pars plana vitrectomy). In some cases, evisceration may be necessary to remove a severe and intractable infection which could result in a blind and painful eye.
In people with acute endophthalmitis, combined steroid treatment with antibiotics have been found to improve visual outcomes, versus patients only treated with antibiotics, but any improvements on the resolution acute endophthalmitis is unknown.
Compassionate Use Treatment: For endophthalmitis, compassionate use or off-label treatments may be considered in certain situations, although they are not standard care. These treatments might include:

1. **Intravitreal Antibiotics**: While standard antibiotics like vancomycin and ceftazidime are commonly used, certain newer antibiotics or antifungal agents could be used experimentally.

2. **Antibacterial Peptides**: Research into antibacterial peptides as an alternative or adjunctive therapy is underway.

3. **Steroids**: Intravitreal steroids, such as dexamethasone, might be used off-label to reduce inflammation, although this is not universally accepted due to potential risks.

4. **Intraocular Antiviral Agents**: For viral causes of endophthalmitis, intravitreal antivirals like ganciclovir might be considered, albeit off-label.

5. **Novel Drug Delivery Systems**: Experimental drug delivery mechanisms, such as sustained-release implants or nanoparticles, are being studied.

6. **Phage Therapy**: The use of bacteriophages to target specific bacterial pathogens is an experimental area of research.

7. **Gene Therapy**: Although very experimental, gene therapy approaches are being explored to combat antibiotic-resistant infections.

These treatments should only be pursued under strict medical and ethical guidelines, often within the realm of clinical trials or emergency use authorizations.
Lifestyle Recommendations: Endophthalmitis is a severe inflammation of the interior of the eye typically caused by infection. While lifestyle recommendations may not directly prevent or manage endophthalmitis, maintaining overall eye health can be beneficial. Here are some general recommendations:

1. **Prioritize Hygiene:** Regularly wash your hands, especially before touching your eyes or applying eye drops.
2. **Proper Care for Contact Lenses:** Follow guidelines for cleaning and handling contact lenses to reduce the risk of infections.
3. **Protective Eyewear:** Use safety goggles in environments with potential eye hazards to prevent injury and contamination.
4. **Regular Eye Exams:** Attend routine eye checkups to monitor for any signs of infection or eye health issues.
5. **Immediate Medical Attention:** Seek prompt medical care for eye injuries or infections to prevent complications like endophthalmitis.
6. **Post-Surgical Care:** If you've had eye surgery, adhere strictly to post-operative care instructions to minimize infection risks.

These steps can help maintain eye health, which is crucial in preventing conditions that could lead to severe complications like endophthalmitis.
Medication: Endophthalmitis is a severe inflammation of the interior of the eye, typically caused by infection. Prompt treatment is crucial and usually involves:

**Antibiotics:**
1. **Intravitreal Antibiotics**: Direct injection into the vitreous cavity, commonly used antibiotics include vancomycin and ceftazidime.
2. **Systemic Antibiotics**: Intravenous or oral antibiotics may be given in addition to intravitreal therapy based on the severity and type of infection.

**Antifungal Agents:**
- For fungal infections, intravitreal antifungal agents like amphotericin B may be used.

**Corticosteroids:**
- Intravitreal or systemic corticosteroids may be administered to reduce inflammation, though their use is controversial and depends on the causative organism and clinical scenario.

**Vitrectomy:**
- Surgical intervention to remove infected vitreous gel may be necessary in severe cases.

Consultation with an ophthalmologist is essential for proper diagnosis and tailored treatment.
Repurposable Drugs: Repurposable drugs for endophthalmitis include:

1. **Vancomycin** - an antibiotic effective against Gram-positive bacteria.
2. **Cefazolin** - an antibiotic used to treat a variety of bacterial infections.
3. **Dexamethasone** - a corticosteroid used to reduce inflammation.

Note: The efficacy and safety of using repurposed drugs should be evaluated on a case-by-case basis.
Metabolites: Endophthalmitis is a severe inflammation of the interior of the eye, usually caused by an infection. Metabolites are not typically the primary focus in the diagnosis or treatment of endophthalmitis. However, the infection can alter the local metabolic environment in the eye.

Nan (nanometers) might be relevant when discussing nanoparticles used in drug delivery systems for treating endophthalmitis. Nanoparticles can penetrate ocular tissues more effectively and enable targeted drug delivery, which can potentially improve therapeutic outcomes for the infection.

If you need more specific information about metabolites or nanotechnology in this context, please provide additional details.
Nutraceuticals: Currently, there isn't strong evidence supporting the use of nutraceuticals for the treatment or prevention of endophthalmitis. Endophthalmitis is a serious ocular infection that typically requires prompt medical treatment, usually involving antibiotics and sometimes surgical intervention. If you suspect endophthalmitis, it's crucial to seek immediate medical attention.
Peptides: Endophthalmitis is a severe inflammation of the interior of the eye usually caused by infection. Peptides have been explored for their antimicrobial properties as potential therapeutic agents in treating infections including endophthalmitis. Nanotechnology can enhance the delivery and efficacy of these peptides through the development of nanoparticles, which can provide targeted and sustained release of antimicrobial agents, minimize toxicity, and improve treatment outcomes.