Treatment of Metastatic Meningococcic Endophthalmitis

Ocular complications of cerebrospinal meningitis are less frequent than they were in years past. Prompt use of meningococcic antitoxin and extensive use of sulfonamide compounds have been responsible for the great reduction in the number of complications. The gravest, most important ocular complication is metastatic endophthalmitis, terminating usually in the formation of an abscess in the vitreous, with subsequent organization, in the formation of a cyclitic membrane and frequently in complete retinal detachment. Endophthalmitis occurs in about 5 per cent of all the cases in epidemics. Lazar 1 cited 30 instances in 575 cases, or 5.2 per cent. Bilateral involvement was present in 9 cases in his series. Lewis 2 reported an incidence of 5.7 per cent in 350 cases, with involvement of both eyes in 4 instances. Epidemic meningitis is primarily an infection of the blood stream, with localization in the meninges and other organs occurring secondarily. Dunphy 3