Endogenous endophthalmitis: a 10-year clinical survey in a single centre

Endogenous endophthalmitis (EE), a distinct form characterized by intraocular infection resulting from hematogenous spread of pathogens, represents a relatively uncommon but clinically significant variant. Although accounting for only 2–8% of all endophthalmitis cases, EE carries substantial risks of severe visual morbidity and potential ocular or systemic complications. Recognizing the existing challenges in cross-study comparisons due to geographic variations, etiological differences, and heterogeneous reporting methodologies, we performed a comprehensive 10-year retrospective review of EE cases to better characterize this sight-threatening condition. A retrospective analysis was conducted on clinical case series from January 2014 to December 2024, involving 44 eyes of 40 patients (11 females and 29 males). Data on demographics, initial symptoms, pre-existing medical conditions, visual acuity, examination findings, therapeutic interventions, and clinical outcomes were collected from detailed medical records. Patients diagnosed with EE were identified using electronic medical records with the keyword “endophthalmitis”, excluding those who had undergone intraocular surgery or experienced ocular trauma.Diagnostic criteria included clinical presentation, ocular imaging, and culture results. Statistical analysis employed descriptive statistical methods. The study cohort comprised 44 eyes from 40 patients with an mean age of 52.68 ± 11.456 years. The mean interval of fever prior to illness onset was 5.67 ± 5.38 days, and patients typically consulted an ophthalmologist after 5.67 ± 5.38 days from ocular symptom onset. Pre-existing medical conditions predisposing to pyogenic liver abscess were present in 38 patients, with diabetes mellitus was present in 31 (77.5%) having an average HbA1c level of 9.7 ± 1.8%. On average, patients waited 12.10 ± 9.14 days from symptom onset to their first hospital visit. Eye-related symptoms were the initial presenting complaint in 55% of cases, while abdominal pain was the primary reason for clinic visits in 35%. Ocular pain and visual disturbances were common presenting complaints, observed in 40% and 37.5% of patients, respectively. Endogenous endophthalmitis remains a rare but serious condition associated with substantial ocular morbidity and diagnostic delays. Our study highlights the importance of prompt recognition and early intervention, particularly in patients with underlying medical conditions such as diabetes mellitus. Improved awareness and diagnostic protocols are essential for better patient outcomes.