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Updated: May 24, 2026
Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
Published on: August 25, 2021
Microbial contamination in open globe injury
1Department of Ophthalmology and Microbiology, Government Medical College Hospital, Chandigarh, India. soniya.bhala@gmail.com
Introduction:
Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy.
Purpose:
To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries.
Material And Methods:
A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis.
Results:
Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p less than 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culture-negative cases.
Conclusion:
Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended.
Insights
Microbial contamination occurs in 26% of open globe injuries (OGI), with Aspergillus being the most common contaminant. Early contamination significantly correlates with endophthalmitis development, highlighting the need for close follow-up.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endophthalmitis is a severe complication of ocular trauma.
- Identifying microbial contaminants is crucial for effective empirical antibiotic therapy.
Purpose of the Study:
- To determine the incidence of microbial contamination in open globe injuries (OGI).
- To identify the spectrum of microorganisms involved in OGI.
Main Methods:
- A prospective study of 50 consecutive OGI cases over two years.
- Intraoperative sampling of conjunctival sac and anterior chamber.
- Cultures of abscised tissue, foreign bodies, and vitreous taps when indicated.
Main Results:
- Microbial cultures were positive in 26% of cases.
- Aspergillus species were the most frequent contaminant (45.6%), followed by Alternaria and Curvularia.
- A significant association was found between initial contamination and the development of endophthalmitis (p<0.05).
Conclusions:
- Initial contamination affects 26% of OGI cases, with fungi like Aspergillus being predominant.
- A strong correlation exists between initial contamination and subsequent endophthalmitis.
- Culture-negative cases showed a trend towards better visual outcomes; close follow-up of contaminated OGI cases is recommended.
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