Painless endophthalmitis after cataract surgery

Pain is one of the classically described symptoms of postoperative bacterial endophthalmitis, and has been thought to be a useful and early warning symptom. Three cases, however, of culture-proved endophthalmitis presented without pain. Detection of abnormal physical findings suggested the diagnosis in each case, and led to the appropriate microbiologic evaluation and therapy. Early and frequent postoperative ocular inspection is the responsibility of the ophthalmologist. Exclusive reliance on symptoms experienced by the patient in the postoperative period is insufficient if complications such as endophthalmitis are to be diagnosed and treated optimally.