Management of Endophthalmitis Following Agricultural Trauma

Dr. Emmanouil Mavrikakis manages a case of endophthalmitis in a 62-year-old female who was referred due to blurred vision and pain in her right eye (RE) after blunt trauma while manipulating some wood branches 6 days prior. The patient's visual acuity was hand motion in the RE and 20/20 in the LE. On examination, a fibrinous membrane with hypopyon was present in the anterior chamber of her RE, and B-scan ultrasound showed vitreous membranes and debris with no signs of retinal detachment. Fundus examination was not possible due to vitreous opacities. A vitreous tap-and-inject procedure was immediately performed using vancomycin, amikacin, and voriconazole. On the following day, the hypopyon was absent but there was no improvement in the patient's visual acuity or vitreous findings. A pars plana vitrectomy, core vitrectomy, and peripheral vitrectomy were performed, followed by intravitreal injection of antibiotics. At the 5-month follow-up, the patient's vision had improved to 20/40.

Financial Disclosures: Dr. Emmanouil Mavrikakis discloses no financial relationships.