Thirteen-Year Review Of Microbial Keratitis–Related Endophthalmitis: Incidence, Clinical Course And Evisceration Rate

To evaluate the incidence, clinical symptoms, therapeutic interventions, and visual outcomes in cases of endophthalmitis secondary to microbial keratitis.

 A specialized tertiary eye care setting. Dhahran, Saudi Arabia 

A retrospective analysis was conducted on 15 patients treated at our ophthalmology department between 2011 and 2024. Data evaluated included clinical findings, pre-existing corneal disease, history of steroid use or ocular trauma, contact lens wear, specialized surgical interventions, identification of causative pathogens, and final visual acuity (VA

• Comorbidities: 46.7% of patients were diabetic.
• Time to Diagnosis: ranged from 1 to 45 days.
• Time to Specialist Treatment: ranged from 3 days to 3 weeks.
• Clinical Presentation: Common signs included eyelid swelling/tenderness (8/15), hypopyon (7/15), vitritis (8/15), and choroidal thickening (7/15).
• Baseline Vision: 11/15 eyes No light perception, 3/15 eyes had light perception, and 3/15 eyes hand motion vision .
• Microbiology: Pathogens were identified in 63.6% of samples.

• outcomes: 73.3% of eyes underwent evisceration. One-patient treated with vitrectomy and his final vision was 20/20. No patient suffered from sympathetic ophthalmia.

Endophthalmitis secondary to microbial keratitis carries a grave prognosis, frequently resulting in total eye loss despite aggressive surgical intervention. Significant delays in both initial clinical diagnosis and specialist referral are primary drivers of these devastating outcomes. These findings underscore the critical necessity for immediate diagnosis and streamlined referral pathways to specialized centers to preserve ocular integrity and mitigate the risk of evisceration.