Clinical Outcomes and Management Strategies in Endophthalmitis: A Case Series

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Endophthalmitis is an intraocular infection due to bacteria or fungi involving the vitreous and/or aqueous. The purpose of this study is to analyse and summarize the outcomes of recent endophthalmitis cases, reviewing and assessing the different management strategies. Methods: A total of 10 cases of endophthalmitis were identified between January 2024 and December 2025 in a tertiary vitreoretinal clinic and were reviewed retrospectively for patient age, sex, aetiology, initial and final visual acuity (VA), management, culture results, complications and secondary interventions. Aqueous humor and vitreous humor were cultured for bacteria and fungi in all of the patients. Results: Of the 10 patients, female to male ratio was 4:6. Mean age was 59.5 (range between 2 and 88). In all the patients the VA on admission was worse than 1.0 logMAR (range between 2.70 and 1.00 logMAR). All the cases are exogenous – 7 after cataract surgery, 1 following filtering bleb surgery, 1 following intravitreal injection and 1 developed after trauma. Every single patient received systemic antibiotic treatment. Drugs of choice were Vancomycin, Moxifloxacin and Ceftriaxone. 70% of the patients had negative culture results. The isolates from the positive culture results were E. faecalis, S. haemolyticus, O. anthropi. Regardless of the culture result, the patients received intravitreal antibiotic injections in addition to the systemic treatment. All of the patients underwent vitrectomy on their initial admission. 360° endolaser photocoagulation was performed and silicone oil tamponade was applied, followed by evacuation after 3-4 months. VA after treatment reached up to 0.15 logMAR (in 2 patients). The most common complication was secondary glaucoma (observed in 2 of the patients). There were no cases of retinal detachment observed in the reviewed group. Conclusions: Cataract surgery is the most frequent cause of exogenous endophthalmitis. All the patients required vitrectomy at some point in their treatment. Early vitrectomy with silicone tamponade has been associated with decreased incidence of retinal detachment after treatment. Prompt diagnosis and adequate treatment are important to prevent complications and avoid visual loss