Value of a centralized surveillance system during a national epidemic of endophthalmitis

A centralized registry of cases was established when it became apparent that an outbreak of Candida parapsilosis endophthalmitis in California was due to intrinsic contamination of a nationally distributed ocular irrigation solution. The purposes were to detect cases, to identify patients at risk, to collect and disseminate clinical information regarding the infection, and to make available information and experience regarding treatment. As a result of these efforts, all patients exposed to the solution were reviewed by their physicians and numerous cases of infection were detected. In contrast, Food and Drug Administration-mandated procedures, traditionally focused on manufacturing standards, were effective in recalling the contaminated solution but failed to provide physicians with adequate information to identify and care for patients at risk.