Endophthalmitis

Q: What are the two types of Endophthalmitis?

Answer: Endophthalmitis as the name suggests means infection within the eye.

It is broadly divided into two types:

• Endogenous
• Exogenous 

Endogenous endophthalmitis occurs due to bacterial or fungal seeding of the eye via the bloodstream. This is because the choroid is highly vascular and is usually seeded first. Infection progresses from the "back of the eye to the front" (posterior to anterior.)

Exogenous endophthalmitis occurs when an infection gets introduced from the outside. The most common reasons are eye surgery, trauma, and extension of fungal infection of the cornea ("fungal keratitis" / "keratomycosis"). It is also called aqueous endophthalmitis, as many times the vitreous chamber is not involved. 

Though this distinction sounds simple but carries significance in management.

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References:

1. Vaziri K, Schwartz SG, Kishor K, Flynn HW Jr. Endophthalmitis: state of the art. Clin Ophthalmol. 2015 Jan 8;9:95-108. doi: 10.2147/OPTH.S76406. PMID: 25609911; PMCID: PMC4293922.

2. Lemley CA, Han DP. Endophthalmitis: a review of current evaluation and management. Retina. 2007 Jul-Aug;27(6):662-80. doi: 10.1097/IAE.0b013e3180323f96. Erratum in: Retina. 2007 Sep;27(7):table of contents. Dosage error in article text. PMID: 17621174.

3. Xie CA, Singh J, Tyagi M, Androudi S, Dave VP, Arora A, Gupta V, Agrawal R, Mi H, Sen A. Endogenous Endophthalmitis - A Major Review. Ocul Immunol Inflamm. 2023 Sep;31(7):1362-1385. doi: 10.1080/09273948.2022.2126863. Epub 2022 Oct 28. PMID: 36306406.