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Post-Operative Endophthalmitis — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlPost-Operative EndophthalmitisSCE Infectious Diseases

A 55-year-old man develops an acute swollen red eye with hypopyon (pus in the anterior chamber) and reduced visual acuity 5 days after cataract surgery. What is the most likely diagnosis and management?

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Correct answer: E — Post-operative bacterial endophthalmitis; urgent intravitreal antibiotics (Vancomycin plus Ceftazidime) and ophthalmology emergency

Post-operative endophthalmitis presents with pain, reduced visual acuity, conjunctival injection, and hypopyon within days of intraocular surgery. This is an ophthalmological emergency. Management is intravitreal injection of antibiotics (Vancomycin 1 mg plus Ceftazidime 2 mg) ± vitrectomy. Common organisms include coagulase-negative staphylococci, S. aureus, and Streptococci. Vitreous tap for culture should be taken before injection. Time to treatment is critical for visual outcome — every hour of delay worsens prognosis.

Reference: RCOphth 2023 – Post-operative endophthalmitis; NICE CKS 2024