[Endophthalmitis]

Endophthalmitis is a rare, but serious complication of intraocular surgery and penetrating injury, and is occasionally seen as a consequence of microbial spread either systemically or from a local focus of infection. Data from 34 patients with endophthalmitis at Haukeland University Hospital from 1988-98 were reviewed. The number of patients with endophthalmitis per year was 0-4, except for 1998 when 11 patients were diagnosed. Six patients had been treated with antibiotics prior to admission and were culture negative. 29 isolates were obtained form the other 27 patients. Pneumococci were identified in eight. Predisposing factors included ocular surgery, penetrating trauma, and periocular or systemic infections. All patients were treated with local and systemic antibiotics (from 1995 with a standardised combination of vancomycin and ceftazidime). Vitrectomy was performed in 22 patients. The visual function was perception of light or worse in six patients prior to the infection, and was the final outcome in 22 patients after the infection. The prognosis was dependent on predisposing factors and the infecting organism. Vitrectomy did not seem to improve the results. This series illustrates the clinical picture of endophthalmitis and current options for treatment. No definite explanation for the increased number of cases seen in 1998 was found.