Management of acute endophthalmitis requires a rapid diagnosis and appropriate treatment or referral. Most cases of endophthalmitis are managed by vitreoretinal specialists who will take a sample of fluid from the eye for culture and inject antibiotics or antifungal agents into the eye on an emergent basis. In cases of light perception vision only, vitrectomy is recommended in addition to culture and antibiotic injection. Cases of endophthalmitis can lead to a complete loss of vision and even the eye if not treated rapidly. However, it is possible to retain good vision if treatment is timely and successful.
Thygeson's superficial punctate keratopathy [ 3 ]
This rare, idiopathic condition usually arises in the younger population (under 24 years). It is characterised by recurrent episodes of pain and foreign body sensation (± blurred vision, red eye, photophobia and tearing) and crumb-like, non-staining white opacities scattered over the corneal surface. It is usually bilateral but asymmetrical. It is managed with topical steroids. Although visual prognosis is good, patients have to be monitored for complications of treatment.
Although evidence for the use of topical antibiotics in an uncomplicated corneal abrasion is lacking, they are usually prescribed with the rationale of preventing superinfection. 4 , 16 , 17 Topical antibiotics are indicated for corneal abrasions caused by contact lens use, foreign bodies, or a history of trauma with infectious or vegetative matter, because there is a higher risk of secondary bacterial keratitis in these cases. 18 For uncomplicated abrasions, options include erythromycin % ophthalmic ointment, polymyxin B/trimethoprim (Polytrim) ophthalmic solution, and sulfacetamide 10% ophthalmic ointment or solution ( Table 2 ) . Topical antibiotics are generally dosed four times a day and continued until the patient is asymptomatic for 24 hours. Ointments are thought to provide better lubrication than solutions, resulting in increased comfort and healing. Preparations containing neomycin should be avoided because of the frequency of contact hypersensitivity. Combination preparations with a topical steroid are contraindicated because topical steroids increase susceptibility to infection and may delay healing. 19