has anyone had experience with endophthalmitis? recovery and antibiotic treatment

[ming24]

Hi has anyone experienced endophthalmitis with rapid onset. I experienced this about 12 hours after cataract surgery. I developed the infection after having a cataract surgery at 8am, had an emergency vitrectomy the following afternoon, approximately 32 hours post surgery with an injection of antibiotic. When diagnosed I could not see at all, no count finger ability, and I do not believe I could see color, just bright light only and was able to detect movement. It is unclear whether I will get all my vision back or not though there has been improvement and I can, after 5 days, see general outlines of things and color, and can recognize things such as books, plates. As of yesterday, I can just barely make out letters on a typewriter keyboard, but things are still very blurry hazy and there is a gauze over everything. I am under the impression that the visual outcome in such situations is not positive and that this is largely dependent upon the type of bacteria, with gram positive and gram negative bacterias resulting in different outcomes. I am 60, did not wear contacts, am highly myopic, and was fitted with a monofocal lens. I am wondering if anyone has had a similar experience and can offer some guidance in terms of time, whether improvements are progressive, and whether the condition can regress with particular forms of bacteria. Thanks.

[ming24]

a brief update: vision has returned in the RE and the doctor's now say I will probably get most of my vision back. They were unable to obtain a culture of the bacteria so it's not known what the bacterial infection was. I was fitted with glasses in September and am now corrected I believe to 20/35 or 20/40, with the possibility that things will still improve in the next few months. I feel very lucky to have gotten much of my sight back.

I have one final query: in my LE, which was not affected by infection and which was operated on July 13th. I had an Alcon Acrysoft Aspheric UV absorbing IOL implanted 13.5D. In LE, in the last three weeks I notice a hazing, a moving gauze curtain, which I did not notice before. Its annoying and it dissipates after looking, but whenever I move my head or especially gaze past a bright window or bright computer screen, I notice the gauze.   It seems always to be moving, usually in the opposite direction that my head is moving. It does not affect clarity of small letters much but it does lead to some dulling of colors etc and it accompanied by floaters, small dark squiggly shapes that move across the visual field.

Will this go away? My two doctors have both examined the eye and say there is nothing structurally wrong with the eye but this moving curtain makes doing intermediate and close up work at the computer more difficult and it sometimes leads to headaches etc. I'm just not clear on why this is happening or what is causing it, and why I did not notice it earlier. One of my doctors said that the fluid was cleared out of the RE during the vitrectomy and the vitreous gel in the LE could show normal clouding with age. Would this explain the moving gauze? I'm just wondering if the brain will eventually discount it, but I'm now nearly two months out of surgery. First op was July 13th. RE was July 31, and emergency vitrectomy was August 1. Thanks again for your time with this

[JohnHaganMD]

I'm very glad you had a return of good vision after such a serious problem. The LE sounds like a vitreous floater, weiss ring or vitreous 'veil"      No safe way to get rid of these but most eventually drop to bottom of eye, move off to side or the brains "tunes them out"

[JohnHaganMD]

Endophthalmitis is rare after cataract surgery but among the most feared complications. While treatment is much improved the ultimate prognosis depends a great deal on the virulence of the organism causing the infection. Most studies show the incidence of this type of infection is about one in 8000 to 10000   I wish best of luck. Often it is weeks to months before the final outcome can be known.

[ming24]

thank you very much Dr. Hagen. My vision has returned somewhat in the right eye, though things still very blurry. Dr. said outcome would not be certain for two to three weeks but that the rapid improvement was a good initial sign that the antibiotic worked. I will keep updating so that this may be useful for others. It was certainly unexpected and frightening.

[JohnHaganMD]

Best of luck.