4th Year MBBS
EYE
Topic 11 — Endophthalmitis & Panophthalmitis
Connect the cause, intraocular damage, clinical findings, investigations and urgent management for rapid KMU revision.
1. THE TOPIC IN ONE CONNECTED FLOW
Endophthalmitis begins when microorganisms enter the internal eye from outside or through the bloodstream. Infection within the aqueous and vitreous cavities triggers intense inflammation and threatens retinal function. If the destructive process extends through the ocular coats and surrounding tissues, the disease progresses to panophthalmitis.
2. KEY CLINICAL CONNECTIONS
Recent surgery or penetrating injury → direct microbial entry → acute intraocular inflammation → rapid visual deterioration.
This is the typical exogenous pathway.
Dense vitritis → obscured fundus → B-scan ultrasonography → assessment of posterior-segment inflammation and structural complications.
The investigation is most useful when direct fundus visualization is lost.
Bloodstream infection → crossing of the blood-ocular barrier → endogenous endophthalmitis → ocular treatment plus treatment of the systemic source.
Blood cultures help connect the eye infection with systemic bacteremia or fungemia.
Extension through ocular coats → chemosis, proptosis and restricted ocular movement → panophthalmitis → urgent systemic and local treatment.
These external or orbital signs indicate disease beyond the vitreous cavity.