The treatment of bacterial endophthalmitis

Restoration of good visual acuity following bacterial endophthalmitis is dependent on prompt diagnosis, immediate treatment, proper selection of antibiotics, high-dose parenteral and periocular antibiotic therapy, and systemic and periocular corticosteroids. Antibiotic selection should be based on the statistical incidence of pathogens rather than on the result of a Gram stain from the aqueous or vitreous humor. Recent experimental studies in the primate eye suggest that there is little to choose between the subconjunctival and retrobulbar routes of antibiotic administration. The role of intravitreal injection of antibiotic, although promising, requires further definition.