Post-traumatic endophthalmitis

Revision as of 14:41, 4 August 2016 by Sara Mehrsefat (talk | contribs)
Jump to navigation Jump to search

WikiDoc Resources for Post-traumatic endophthalmitis

Articles

Most recent articles on Post-traumatic endophthalmitis

Most cited articles on Post-traumatic endophthalmitis

Review articles on Post-traumatic endophthalmitis

Articles on Post-traumatic endophthalmitis in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Post-traumatic endophthalmitis

Images of Post-traumatic endophthalmitis

Photos of Post-traumatic endophthalmitis

Podcasts & MP3s on Post-traumatic endophthalmitis

Videos on Post-traumatic endophthalmitis

Evidence Based Medicine

Cochrane Collaboration on Post-traumatic endophthalmitis

Bandolier on Post-traumatic endophthalmitis

TRIP on Post-traumatic endophthalmitis

Clinical Trials

Ongoing Trials on Post-traumatic endophthalmitis at Clinical Trials.gov

Trial results on Post-traumatic endophthalmitis

Clinical Trials on Post-traumatic endophthalmitis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Post-traumatic endophthalmitis

NICE Guidance on Post-traumatic endophthalmitis

NHS PRODIGY Guidance

FDA on Post-traumatic endophthalmitis

CDC on Post-traumatic endophthalmitis

Books

Books on Post-traumatic endophthalmitis

News

Post-traumatic endophthalmitis in the news

Be alerted to news on Post-traumatic endophthalmitis

News trends on Post-traumatic endophthalmitis

Commentary

Blogs on Post-traumatic endophthalmitis

Definitions

Definitions of Post-traumatic endophthalmitis

Patient Resources / Community

Patient resources on Post-traumatic endophthalmitis

Discussion groups on Post-traumatic endophthalmitis

Patient Handouts on Post-traumatic endophthalmitis

Directions to Hospitals Treating Post-traumatic endophthalmitis

Risk calculators and risk factors for Post-traumatic endophthalmitis

Healthcare Provider Resources

Symptoms of Post-traumatic endophthalmitis

Causes & Risk Factors for Post-traumatic endophthalmitis

Diagnostic studies for Post-traumatic endophthalmitis

Treatment of Post-traumatic endophthalmitis

Continuing Medical Education (CME)

CME Programs on Post-traumatic endophthalmitis

International

Post-traumatic endophthalmitis en Espanol

Post-traumatic endophthalmitis en Francais

Business

Post-traumatic endophthalmitis in the Marketplace

Patents on Post-traumatic endophthalmitis

Experimental / Informatics

List of terms related to Post-traumatic endophthalmitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Post-traumatic bacterial endophthalmitis occurs following penetrating ocular injuries. Post-traumatic endophthalmitis associated with a greater variety of organisms. The most common isolated organisms include Gram-positive Staphylococcus epidermidis and Streptococcus (as a part of the normal skin flora and regularly contaminate open wounds). Bacillus cereus is ranked second and some cases are polymicrobial.[1][2]

Historical Perspective

Classification

Pathophysiology

Pathogenesis

Post-traumatic bacterial endophthalmitis occurs following penetrating ocular injuries. Following penetrating injury, the eye globe integrity disturbed. Penetrating ocular injuries are accompanied by infection at a much higher rate compere to ocular surgery. The broad prevalence range is due to factors such as:

  • Presence of an intraocular foreign body
  • Delay primary globe repair
  • Location and extent of laceration of the globe

Post-traumatic endophthalmitis associated with a greater variety of organisms. The most common isolated organisms include Gram-positive Staphylococcus epidermidis and Streptococcus (as a part of the normal skin flora and regularly contaminate open wounds). Bacillus cereus is ranked second and some cases are polymicrobial.[1][2]

Causes

Post-traumatic bacterial endophthalmitis

Common causes of post-traumatic bacterial endophthalmitis include:[3][1][2]

Post-traumatic fungal endophthalmitis

Common causes of post-traumatic fungal endophthalmitis include:

Differentiating Post-traumatic Endophthalmitis from Other Diseases

Epidemiology and Demographics

The incidence of traumatic endophthalmitis may be decreasing due to earlier wound closure and prompt initiation of antibiotics. Post-traumatic endophthalmitis accounts for 25,000 to 31,000 cases per 100,000 individuals with endophthalmitis.

Prevalence and Incidence

  • The incidence of post-traumatic endophthalmitis was estimated to range from 3.300 to 30,000 per 100,000 individuals with penetrating ocular trauma.[1][2]
  • The incidence of post-traumatic endophthalmitis was estimated to range from 1,300 to 61,000 per 100,000 individuals with intraocular foreign body.[1][2]

Post-traumatic endophthalmitis accounts for 25,000 to 31,000 cases per 100,000 individuals with endophthalmitis.

Risk Factors

Common risk factors in the development of post-traumatic bacterial endophthalmitis include:[1][2]

  • Retained intraocular foreign bodies
    • Non-metallic intraocular foreign body (IOFB)
  • Injury in a rural setting
  • Delay in repair more than 24 hours
  • Disruption of the lens

Screening

Natural History, Complications, and Prognosis

Natural History

Post-traumatic endophthalmitis is a medical emergency. If left untreated, It may lead to panophthalmitis, corneal infiltration, corneal perforation, and ultimately permanent vision loss.

Complications

Prognosis

Post-traumatic bacterial endophthalmitis is associated with particularly very poor visual outcome. Only 22% to 42% patients with post-traumatic bacterial endophthalmitis obtain a final visual acuity of 20/400 or better.[1][4]

Diagnosis

Diagnostic Criteria

History and Symptoms

Posttraumatic bacterial endophthalmitis may occur within hours after the trauma or up to several weeks after injury. Symptoms include decreased vision, pain greater than expected, and lid swelling.

Physical Examination

Laboratory Findings

Imaging Findings

X Ray

Plain film x ray is helpful for the detection of intra ocular foreign bodies (IOFBs) igiven the low cost and ease of interpretation. However, it may detection of only about 40% of intra ocular foreign bodies (IOFBs).

CT

Orbital CT scan is helpful for localization of metallic intra ocular foreign bodies (IOFBs) in the setting of trauma. [1][4]

MRI

Orbital MRI scan is helpful for localization of intra ocular foreign bodies (IOFBs) that may be radiolucent on CT in the setting of trauma. However, metallic IOFB must be excluded first.[1][4]

Ultrasound

On ocular ultrasonography, endophthalmitis may characterized by anterior vitreous haze echoes and retinochoroidal thickening.[3][1]

Other Imaging Findings

Orbital echography is helpful for assessment of vitreous opacification, presence of (IOFBs), status of the posterior hyaloid face, and retinal detachment in a patient with either post-traumatic endophthalmitis.[1][4]

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 Kernt M, Kampik A (2010). "Endophthalmitis: Pathogenesis, clinical presentation, management, and perspectives". Clin Ophthalmol. 4: 121–35. PMC 2850824. PMID 20390032.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Essex RW, Yi Q, Charles PG, Allen PJ (2004). "Post-traumatic endophthalmitis". Ophthalmology. 111 (11): 2015–22. doi:10.1016/j.ophtha.2003.09.041. PMID 15522366.
  3. 3.0 3.1 Durand ML (2013). "Endophthalmitis". Clin Microbiol Infect. 19 (3): 227–34. doi:10.1111/1469-0691.12118. PMC 3638360. PMID 23438028.
  4. 4.0 4.1 4.2 4.3 Affeldt JC, Flynn HW, Forster RK, Mandelbaum S, Clarkson JG, Jarus GD (1987). "Microbial endophthalmitis resulting from ocular trauma". Ophthalmology. 94 (4): 407–13. PMID 3495766.


Template:WS Template:WH