Intraocular infection: Endophthalmitis/panophthalmitis/ Candida septicaemia/ AIDS and the eye

Question 1

Endophthalmitis/panophthalmitis

Answer 1

Rare conditions happen as a complication of intraocular surgery. Can happen from eye trauma or illness too
Endophthalmitis- caused by bacterial/fungal infection that caused inflammation/immune response and affects inside of eye only.
Panophthalmitis- when it spreads to all the eye ball and orbit.

Signs and symptoms:
- fulminating (develops suddenly and severely) within eye next day or 6 months after with little/no pain
- Eye pain
- reduced vision/ visual acuity
- lid swelling
- Pus in the eye

Treatment
Diagnosis and treatment = URGENT refferal. Diagnosis normally by eye exam or ultrasound.
Can use antibiotic, antifungal, corticosteroid.

Question 2

Candidia septicaemia

Answer 2

Fungal origin. Leads to candidaemia.

Symptoms: blurriness, photophobia, vision changes

Antifungal treatment needed.
- Anidulafungin.
- Caspofungin.
- Fluconazole.
- Micafungin

Question 3

AIDS and the eye

Answer 3

CD4+ T-lymphocyte count used to predict ocular infection in HIV +ve ppl.
CD4+ T-cell count <100 cells/mm3 can lead to retinal or conjunctival microvasculopathy, varicella-zoster virus (VZV) retinitis, mycobacterium avium complex infection and HIV encephalopathy.

Treatment
IV aciclovir followed by oral aciclovir or an ALT antiviral agent can be used to treat it.