Related Experiment Video
Updated: Dec 15, 2025
Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
Fungal endophthalmitis: A 20-year experience at a tertiary referral centre
Gursimrat K Bhullar1,2, Rosie C H Dawkins1,2,3, Rodger A Paul1
1The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Importance:
Fungal endophthalmitis is an uncommon and serious intraocular infection, often with poor outcomes. This study examines the trend in this disease over 20 years, to inform clinician decision-making and optimize patient outcomes.
Background:
Due to infrequent presentation of fungal endophthalmitis, there is limited understanding to formulate a standardized approach to management.
Design:
A prospective case series over the period January 1, 1999 to December 31, 2018.
Participants:
Patients with clinically diagnosed fungal endophthalmitis managed at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Methods:
Review of the Victorian Endophthalmitis Registry for endophthalmitis episode of each patient.
Main Outcome Measures:
Patient demographics, co-morbidities, visual acuity (VA) at presentation, aetiology, treatment, microbiology results and final VA outcome.
Results:
Eighty-four cases of fungal endophthalmitis were identified over the study period with a median age of 43.5 years [IQR 30.8-63.0]. Then, 65.5% (n = 55) of patients were male; 81.0% (n = 68) of these cases were secondary to endogenous causes, of which 55.9% were associated with intravenous drug use (IVDU). Among the exogenous causes, penetrating eye injury (56.3%) was the most common aetiological factor. Thirty-nine patients (46.4%) grew Candida species from ocular fluid specimens, all of which were sensitive to fluconazole.
Conclusion And Relevance:
Our case series provides important insights into fungal endophthalmitis-a high degree of suspicion for fungal endophthalmitis in patients with history of IVDU, and relatively good outlook for vision when Candida is the causative organism. This should allow institutions to implement a standardized management strategy based on evidence.
Insights
Fungal endophthalmitis is a serious eye infection. This study found that Candida infections, often linked to intravenous drug use, have a good visual outcome with fluconazole treatment.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Fungal endophthalmitis is a rare but severe intraocular infection with challenging management due to infrequent occurrences.
- Limited understanding exists for a standardized approach to treating fungal endophthalmitis.
Purpose of the Study:
- To analyze trends in fungal endophthalmitis over 20 years.
- To inform clinical decision-making and improve patient outcomes for this serious eye infection.
Main Methods:
- A prospective case series was conducted from January 1, 1999, to December 31, 2018.
- Data was collected from the Victorian Endophthalmitis Registry for 84 patients diagnosed with fungal endophthalmitis.
Main Results:
- Candida species were identified in 46.4% of cases and showed sensitivity to fluconazole.
- Intravenous drug use was a significant factor in endogenous fungal endophthalmitis (55.9%).
- Penetrating eye injury was the leading cause of exogenous fungal endophthalmitis (56.3%).
Conclusions:
- A high index of suspicion for fungal endophthalmitis is crucial in patients with a history of intravenous drug use.
- Favorable visual prognoses are associated with Candida-related endophthalmitis.
- Evidence-based standardized management strategies for fungal endophthalmitis can be developed.
Related Concept Videos
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment