Showing papers on "corneal ulcer published in 2001"

The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal

Abstract: AIMS To determine the incidence of ocular trauma and corneal ulceration in the district of Bhaktapur in Kathmandu Valley, and to determine whether or not topical antibiotic prophylaxis can prevent the development of ulceration after corneal abrasion. METHODS A defined population of 34 902 individuals was closely followed prospectively for 2 years by 81 primary eye care workers who referred all cases of ocular trauma and/or infection to one of the three local secondary eye study centres in Bhaktapur for examination, treatment, and follow up by an ophthalmologist. All cases of ocular trauma were documented and treated at the centres. Individuals with corneal abrasion confirmed by clinical examination who presented within 48 hours of the injury without signs of corneal infection were enrolled in the study and treated with 1% chloramphenicol ophthalmic ointment to the injured eye three times a day for 3 days. RESULTS Over the 2 year period there were 1248 cases of ocular trauma reported in the population of 34 902 (1788/100 000 annual incidence) and 551 cases of corneal abrasion (789/100 000 annual incidence). The number of clinically documented corneal ulcers was 558 (799/100 000 annual incidence). Of the 442 eligible patients with corneal abrasion enrolled in the prophylaxis study, 424 (96%) healed without infection, and none of the 284 patients who were started on treatment within 18 hours after the injury developed ulcers. Four of the 109 patients (3.7%) who presented 18–24 hours after injury developed infections, and 14 (28.6%) of the 49 patients who presented 24–48 hours subsequently developed corneal ulceration. CONCLUSIONS Ocular trauma and corneal ulceration are serious public health problems that are occurring in epidemic proportions in Nepal. This study conclusively shows that post-traumatic corneal ulceration can be prevented by topical application of 1% chloramphenicol ophthalmic ointment in a timely fashion to the eyes of individuals who have suffered a corneal abrasion in a rural setting. Maximum benefit is obtained if prophylaxis is started within 18 hours after injury.

Intracameral amphotericin B: initial experience in severe keratomycosis.

Abstract: Purpose Fungal keratitis is a significant cause of ocular morbidity in India. The most commonly implicated fungi are Aspergillus spp. Patients often present with hypopyon, which usually contains fungal elements. The treatment is difficult owing to poor intraocular penetration of most available antifungal agents. This study evaluated the results of intracameral injection of amphotericin B in natamycin resistant cases of severe keratomycosis. Methods Three patients of culture proven Aspergillus flavus corneal ulcer with hypopyon not responding to topical natamycin 5%, amphotericin B 0.15%, and oral itraconazole were administered intracameral amphotericin B. The first case received 7.5 microg in 0.1 mL followed by two subsequent injections of 10 microg in 0.1 mL each, the second case received two injections of 10 microg in 0.1 mL, and the third patient received a single dose of 10 microg in 0.1 mL. Culture of the aqueous sample also grew A. flavus in all three cases. Results All three cases responded favorably, with the ulcer and hypopyon clearing completely. There was no clinical evidence of corneal or lenticular toxicity in any patient. Conclusions Intracameral amphotericin B may be a useful modality in the treatment of severe keratomycosis not responding to topical natamycin. It ensures adequate drug delivery into the anterior chamber and may be especially useful to avoid surgical intervention in the acute stage of the disease.

Clear corneal wound infection after phacoemulsification.

Abstract: Objective To evaluate clear corneal wound infections after phacoemulsification. Materials and Methods The medical records of 7 patients with clear corneal wound infections after phacoemulsification were reviewed retrospectively. Data that were reviewed included patient age, sex, onset of symptoms and signs after surgery, possible risk factors for infection, concomitant ocular disease, use of perioperative prophylactic antibiotics and steroids, culture and antibiotic sensitivity results, treatment regimen, and outcome. Results The median onset of signs and symptoms after surgery was 10 days (range, 4-60 days). Corneal cultures yielded methicillin-resistant Staphylococcus aureus in 2 cases, Streptococcus pneumoniae in 1 case, and Staphylococcus epidermidis in 1 case. Cultures yielded no microorganisms for 1 patient. Corneal cultures were not obtained in 2 patients. In 3 of the 4 culture-positive cases, the isolated microorganisms were resistant to the perioperative prophylactic antibiotics(fluoroquinolones and tobramycin) that were used. No possible risk factors were noted except use of topical steroids 4 times a day without antibiotic coverage for iritis before referral in one of our patients. Six of these 7 wound infections healed with topical antibiotic therapy. One of the patients required lamellar keratectomy and conjunctival flap for complete healing. In 4 of the 7 cases, best-corrected visual acuity at the last follow-up visit was better than 20/40. Conclusions Clear corneal wound infection after phacoemulsification is a serious complication of cataract surgery. Infections are caused by gram-positive organisms sensitive to bacitracin and the combination of trimethoprim-sulfamethoxazole but often resistant to aminoglycosides and/or fluoroquinolones.

Corneal melt as the initial presentation of primary Sjögren's syndrome.

Abstract: Corneal melting is a rare complication of S ogren's syndrome (SS). Previously reported cases of corneal ulceration occurred in patients with established SS, usually secondary to RA. We describe the first case of corneal ulceration with stromal melting as the initial presentation of primary SS. A 79-year-old man without prior sicca symptoms developed a large sterile corneal ulcer that required extensive treatment over several months with ocular lubricants, systemic immunosuppressives, and surgical repair. Evaluation for an underlying connective tissue disease revealed positive antinuclear antibodies (1:640 speckled) and anti-SSA antibody. A lip biopsy established the diagnosis of SS. Ulceration later occurred in the contralateral eye. Two years after the last corneal ulcer and no longer taking prednisone, the patient's ocular disease remained quiescent taking azathioprine 175 mg and hydroxychloroquine 400 mg daily. This case highlights the potential for primary SS to present with serious ocular complications despite lack of a priori sicca symptoms, as well as the importance of immunosuppressive therapy in the treatment of this complication.

Ciprofloxacin microprecipitates and macroprecipitates in the human corneal epithelium

Abstract: In 4 corneal transplantation patients treated preoperatively with ciprofloxacin ophthalmic drops, microprecipitates associated with damaged corneal epithelium were noted in 2 patients. Another patient developed a large macroprecipitate in a corneal ulcer. All specimens were examined by electron microscopy and high-pressure liquid chromatography. The crystalline precipitates were pure ciprofloxacin. The macroprecipitate demonstrated a large zone of inhibition on agar plates seeded with a susceptible organism at 24 and 48 hours. It was bioactive and bioavailable in vitro.

Bacteriologic and clinical efficacy of ofloxacin 0.3% versus ciprofloxacin 0.3% ophthalmic solutions in the treatment of patients with culture-positive bacterial keratitis.

Abstract: PURPOSE: To compare the efficacy and safety of ofloxacin 0.3% ophthalmic solution with ciprofloxacin 0.3% ophthalmic solution in patients with culture-positive bacterial keratitis. METHODS: Patients with a microbiologic diagnosis of bacterial keratitis were included in this double-masked, parallel-group study and were randomized to treatment with either ofloxacin 0.3% or ciprofloxacin 0.3% ophthalmic solution. One drop of the study medication was instilled during the daytime according to the following schedule: every half-hour on study day 1, every hour on days 2 through 4, and every 2 hours on days 5 through 21. Healing, the primary outcome measure, was defined as complete reepithelialization, accompanied by nonprogression of stromal infiltrate for 2 days. Secondary outcome measures included signs and symptoms of infection. Patients were monitored throughout the study period for any adverse events. RESULTS: A total of 217 patients completed the study: 112 were treated with ofloxacin and 105 were treated with ciprofloxacin. Streptococcus pneumoniae was the most commonly encountered pathogen in all patients. Complete corneal reepithelialization occurred in 85% of those treated with ofloxacin and in 77% of those treated with ciprofloxacin (p = 0.32). The average time to corneal ulcer healing was 13.7 days in those treated with ofloxacin and 14.4 days in those treated with ciprofloxacin. Both treatments were well tolerated with no patient discontinuing the study because of side effects. CONCLUSION: Ofloxacin 0.3% and ciprofloxacin 0.3% ophthalmic solutions are effective and safe in the treatment of patients with culture-positive bacterial keratitis.

Corneal co-infection with Scedosporium apiospermum and Acanthamoeba after sewage-contaminated ocular injury.

Abstract: PURPOSE To describe a corneal co-infection with the fungus Scedosporium apiospermum and Acanthamoeba that result in spontaneous corneal perforation. METHODS A 27-year-old man presented due to severe ocular pain in his left eye caused by a corneal ulcer. The patient was injured 7 days before presentation by metallic thread contaminated by sewage. Corneal scrapping and deep stromal biopsy were obtained and stained for microscopic evaluation with periodic acid-Schiff, Giemsa, and Gomori's methenamine silver stains. Samples were sent for aerobic and anaerobic bacterial and fungal cultures. RESULTS Corneal biopsy and corneal scrapping showed viable Acanthamoeba cysts in the corneal stroma and S. apiospermum micelle, respectively. The fungal culture was sensitive to ketoconazole, miconazole, econasole, and traconazole. Devastating corneal perforation occurred despite aggressive antifungal and antiamoebic topical and systemic treatment initiated after diagnosis. The corneal button showed a necrotic tissue devoid of inflammatory cells and microorganisms. CONCLUSION S. apiospermum and Acanthamoeba may co-infect immune privilege sites, such as the cornea, in immunocompetent hosts. Compromised corneal surface, e.g., after trauma by sewage-contaminated objects, may increase the susceptibility for such devastating coinfection. Prevention may be possible by use of protective eyewear by high-risk individuals. Treatment should be initiated promptly with broad-spectrum antimicrobial agents after ocular injury by sewage-contaminated objects. Repeated corneal cultures and biopsies, if the cultures are negative, are warranted. Corticosteroids should be withheld until the causative agents are identified and targeted treatment is initiated.

An unusual case of fungal keratitis: Metarrhizium anisopliae.

Abstract: PURPOSE: To report a case of fungal keratitis caused by Metarrhizium anisopliae, which to our knowledge is the first reported case in the United States. METHOD: Case report. RESULTS: A 36-year-old female librarian who wore extended-wear soft contact lenses was seen by an ophthalmologist on September 11 for an irritated right eye, and a corneal ulcer was diagnosed. Symptoms increased by September 27, and the patient was referred to another ophthalmologist who cultured the ulcer and had scrapings examined, which were Gram-negative for microorganisms. The patient was referred to one of the authors (W.J.R.). Her exam on October 1 showed vision corrected to 20/25 OD, a 5-mm epithelial defect with a 2.5-mm anterior stromal grayish-type infiltrate, and a quiet anterior chamber; the eye did not appear to be inflamed. The patient was reexamined on October 4 and was noted to have worsening vision. Because the initial cultures remained negative, the patient underwent a corneal biopsy, Gram stain, and cultures on October 6. Scrapings at the time of the biopsy revealed septate hyphal elements, as did the biopsy specimen, and on October 7, the patient was started on a treatment of bacitracin ointment once a day and natamycin 5% every hour. The eye gradually quieted down. A mold growing from the biopsy culture, which had been sent to a reference laboratory in San Antonio, Texas, was identified as M. anisopliae var. anisopliae. The patient was subsequently fitted with a rigid gas permeable lens, which resulted in a best-corrected visual acuity of 20/20, although glare remained a major problem. CONCLUSION: Although not previously reported in the United States, M. anisopliae can cause a keratomycosis, and one must consider this common insect pathogen in the differential diagnosis of fungal keratitis.

Amniotic membrane transplantation for persistent corneal epithelial defect.

Abstract: Persistent corneal epithelial defects with or without ulceration are a serious and urgent clinical problem which can be complicated by microbial infections and thus threaten patients' vision. Experimental studies have revealed that corneal epithelial injuries with or without involvement of the stroma result in rapid healing so long as the eye retains its normal ocular surface defences and possesses healthy limbal epithelial stem cells (for a review see Tseng1). Therefore, whenever there is a persistent defect or ulcer the diagnostic examination should first be directed to ruling out limbal stem cell deficiency, followed by analysis of the integrity of the ocular surface defence governed by neuroanatomical integration of both trigeminal and facial nerves (for a review see Solomon et al 2). Although the actual aetiology may arise from multiple influences and be exogenously or endogenously triggered, the most common denominator is neurotrophic keratopathy, in which trigeminal denervation simultaneously abolishes reflexes controlling tear secretion and lid blinking and closure. When medical treatments fail and the defect or ulcer persists (for example, for …

Orthokeratology induced infective corneal ulcer

Abstract: Objective To investigate the clinical course, treatment and outcome of infective corneal ulcer induced by orthokeratology. Methods Sixteen cases of infective corneal ulcer caused by orthokeratology were reported, including 7 cases of pseudomonas corneal ulcers, 8 cases of acanthamoeba keratitis and 1 case of mycotic keratitis. Smears and cultures from corneal scrapings for bacteria, fungi and amoeba were performed for all of the patients. According to the results of pathogenic microorganisms, different therapeutic approaches were given. Lamellar keratoplasty or penetrating keratoplasty was performed for 9 patients whose corneal lesions were serious and unresponsive to medical therapy. Results After medical treatment or keratoplasty, corneal infections of all the patients were controlled. The visual acuity of most cases was improved. Conclusions The infective corneal ulcer is the most serious complication of orthokeratology. The treatment of infective corneal ulcer should be directed toward the elimination of the pathogenic microorganisms from the cornea. Keratoplasty continues to have a central role in the management of some advanced cases. Although the infections can be controlled, the vision of these patients is seriously damaged.

Aureobasidium pullulans scleritis following keratoplasty: a case report.

Abstract: Fungal scleritis is a rare entity. A 50-year-old patient with culture proven Aureobasidium pullulans corneal ulcer underwent therapeutic keratoplasty. He developed scleritis 5 days following surgery. Although the patient had symptomatic improvement after antifungal therapy, surgical debridement, and cryotherapy, visual improvement was only marginal. Aureobasidium pullulans should be looked for as a cause for keratomycosis and scleromycosis, especially in tropical countries.

Fungal keratitis in a daily disposable soft contact lens wearer.

Abstract: Purpose: To report the first case of fungal keratitis in a patient wearing daily disposable soft contact lenses. Methods: Case Report. A 20-year-old white female in good health developed corneal ulcer in her left eye associated with daily disposable soft contact lens wear. There was no history of trauma to the left eye, and she denied overnight wear. Corneal scrapings were taken, and the patient was started on intensive tobramycin 14 mg/mL and cefazolin 50 mg/mL topical therapy for suspected bacterial keratitis. After 3 days of antibacterial therapy, the ulcer worsened. The cultures were negative as were the Gram stain and Gomori's methenamine silver stain. Initial cultures and stains were then repeated with the addition of a culture for herpes simplex virus. The developing clinical picture was suspicious for fungal keratitis. The patient was then started on intensive vancomycin 2%, natamycin 5%, and continued on fortified tobramycin. Three days after the second corneal scrapings were performed, a positive fungal culture was obtained for Fusarium sp. Vancomycin and tobramycin were then discontinued and amphotericin B 0.15% was added to natamycin 5% with the continuation of intensive topical therapy. Results: The patient's keratitis was successfully treated with intensive double antifungal therapy. Conclusions: Infectious keratitis in daily disposable soft contact lens wear is an unusual occurrence. To our knowledge, there is no previous case of fungal keratitis occurring in patients wearing daily disposable lenses. This case emphasizes the importance of considering fungus in the differential diagnosis for keratitis even in daily disposable contact lens wearers.

Multilayer vs. monolayer amniotic membrane transplantation for deep corneal ulcer treatment.

Abstract: The purpose of the study was to evaluate the efficacy of multilayer amniotic transplantation (AMT) for reconstruction of corneal stroma and epithelium. Corneal ulcer (28) was a consequence of a previous infectious or neurotrophic keratitis. In the first group (17) ulcer was covered with monolayer AM, while in the other group (11) there were two or more layers of AM situated in the ulcer and the whole cornea was covered with AM sheet. Monolayer AMT was successful in 64% while the multilayer AMT success rate was 72%. AM gradually dissolved within 3-6 postoperative weeks. AM transplantation facilitates rapid healing of corneal epithelium, reduces inflammation and stimulates epithelial cell regrowth. In eyes with deep corneal ulcer multilayer technique proved to be better then monolayer procedure.

The clinical picture of vernal kerato-conjunctivitis in Uganda.

Abstract: Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral, interstitial inflammation of the conjunctiva, resolving spontaneously after a course of several years and characterised by giant papillae (with a cobblestone appearance) on the tarsal conjunctiva, a discrete or confluent gelatinous hypertrophy of the limbal conjunctiva, and a distinct type of keratitis. It is associated with intense itching, redness or brownness, lacrimation, photophobia and a mucinous, ropy discharge containing eosonophils. VKC is a type 1 hypersensitivity reaction but with additional immune mechanisms involved in its pathogenesis. VKC has a global distribution with a widely varying incidence. It is less common in northern Europe and North America, and more common in the African continent, the Mediterranean countries, in Central and South America, and the Indian subcontinent.1,2 All patients in this study were indigenous Africans, and all had been exposed to similar environmental conditions. Vernal keratoconjunctivitis affecting the limbus (left), the conjunctiva and cornea (right). The conjunctiva has pronounced papillae (‘cobblestones’) and fluorescein dye shows a corneal ulcer Photos: John Sandford-Smith

Infectious crystalline keratopathy in an immunosuppressed patient.

Abstract: Purpose: To report a case of infectious crystalline keratopathy (ICK) in a patient with systemic malignancy on immunosuppressive chemotherapy. The patient wore frequent replacement contact lenses on an extended wear basis. Methods: A 51-year-old female with carcinoma of the breast and systemic metastases was referred for a corneal ulcer. She received intravenous docetaxel, trastuzumab, and systemic dexamethasone. She wore frequent replacement Acuvue lenses on an extended wear basis. Her visual acuity was 20/200 in the right eye and 20/400 in the left eye. The right eye examination revealed diffuse superficial punctate keratopathy. In the left eye, there was a 3.8 x 4.5 mm corneal infiltrate with projecting crystalline processes. Corneal scrapings were performed for smears and cultures. Treatment with topical fortified cefazolin and fortified tobramycin every hour around the clock was initiated. Results: Culture of the corneal scrapings grew Streptococcus anginosus and Staphylococcus aureus. There was a good response to medical therapy. When last seen after 4 weeks of treatment, the infiltrate measured about 1 mm and the visual acuity was 20/40 with pinhole. Conclusions: Systemic immunosuppression may be a predisposing factor for the development of ICK. This case suggests that debilitated patients may be at risk for unusual infections and should be discouraged from overnight wear of contact lenses.

Keratolysis in a patient with pemphigus vulgaris.

Abstract: Editor,—Pemphigus vulgaris is an autoimmune, blistering disease of the skin and mucous membranes.1 The characteristic ocular finding is conjunctivitis, and corneal involvement is rare.2 3 We present a case with pemphigus vulgaris with severe keratolysis that required a corneal transplantation. ### CASE REPORT A 41 year old man had suffered from pemphigus vulgaris for 2 years, and prednisolone 40 mg/day and cyclosporine 300 mg/day had been prescribed. He was admitted to the Hamamatsu University Hospital on 15 March 1999 with an acute exacerbation of the symptoms because of non-compliance with the corticosteroid therapy. He returned on 17 March 1999 because of increased discharge and visual loss in both eyes. His visual acuity was 20/20 right eye and 20/20 left eye, and his intraocular pressure was 24 mm Hg right eye and 20 mm Hg left eye. No remarkable findings were observed …

Atypical Herpes simplex keratitis (HSK) presenting as a perforated corneal ulcer with a large infiltrate in a contact lens wearer: multinucleated giant cells in the Giemsa smear offered a clue to the diagnosis

Abstract: To report a case of atypical herpes simplex keratitis initially diagnosed as bacterial keratitis, in a contact lens wearer. Case report of an 18-year-old woman using contact lenses who presented with pain, redness and gradual decrease in vision in the right eye. Examination revealed a paracentral large stromal infiltrate with a central 2-mm perforation. Corneal and conjunctival scrapings were collected for microbiological investigations. Corneal tissue was obtained following penetrating keratoplasty. Corneal scraping revealed no microorganisms. Giemsa stained smear showed multinucleated giant cells. Conjunctival, corneal scrapings and tissue were positive for herpes simplex virus - 1 (HSV) antigen. Corneal tissue was positive for HSV DNA by PCR. Atypical HSV keratitis can occur in contact lens wearers. A simple investigation like Giemsa stain may offer a clue to the diagnosis.

Amniotic membrane transplantation for ocular surface reconstruction

Abstract: PANIDA KOSRIRUKVONGS, M.D.*,***, YONGYUTRA VAJARADUL,M.D.**,*** Objective : To study the efficacy of amniotic membrane transplantation in various indica- tions for ocular surface reconstruction. Method : Amniotic membrane transplantations were performed in 140 eyes (130 patients) for ocular surface reconstruction. The indications for the corneal group were limbal stem cell defi- ciency, bullous keratopathy, persistent epithelial defect, band keratopathy, prosthesis, corneal ulcer and acute chemical burn. The indications for the conjunctival group were grafts for pterygium, conjunctival tumors, symblepharon, and covering the scleral graft. Results : Success was noted in 75.7 per cent (106/140) eyes, partial success in 17.9 per cent (251140) eyes, and failure in 6.4 per cent (9/140) eyes for a mean follow-up of 6.6 months (1-19 months). The success and partial success rate were 80.6 per cent (54/67), 14.9 per cent (10/67) in the corneal group and 71.2 per cent (52173), 20.6 per cent (15173) in the conjunctival group. Conclusion : Amniotic membrane transplantation can solve some difficult ocular surface problems, and can be used to promote epithelial healing, reduce inflammation and scarring. Key word : Amniotic Membrane, Amniotic Membrane Transplantation, Corneal Surface recon- struction, Conjunctival Surface Reconstruction, Limbal Stem Cell Deficiency, Persis- tent Epithelial Defect, Conjunctival Tumor, Pterygium, Symblepharon

Corneal ulcers in patients with Apert syndrome.

Abstract: Morbidity from corneal ulcers is often severe in patients with Apert syndrome. These patients are at an increased risk of developing corneal ulcers because of the compromised corneal environment secondary to exophthalmos. During the past 6 years, three of five patients treated for Apert syndrome at our hospital have developed corneal ulcers. We present a case series discussing each patient, reasons for the development of ulceration, treatment, and outcomes. Morbidities in our group of patients included decreased visual acuity, opacified corneas, amblyopia, and blindness. Treatment is often difficult and complex. Therefore, an ophthalmologist should be an active team member in treating Apert patients.

Ulcus rodens: Ein Plattenepithelkarzinom der Bindehaut mit massiver intraokularer Invasion - eine Kasuistik

Abstract: Background: Squamous cell carcinoma of the conjunctiva is a mostly solitary growing tumor located at the limbus region, which seldom invades the eye. We present an unusual case of conjunctival carcinoma with marked intraocular involvement, which appeared primarely as a chronic inflammation with corneal ulcer. Case report: A 89-year-old female patient was referred to our institution with a suspected ulcus rodens of the cornea. Since one year a refractory conjunctivitis persisted despite of different local treatment. At first presentation, a marked bacterial keratokonjunctivitis with circular necrosis of the conjunctiva, corneal infiltration and perforation was seen. Visual acuity of the right eye was light perception. The left eye was unremarkable. Enucleation of the right eye was performed. Histopathologic examination revealed the diagnosis of squamous cell carcinoma of the conjunctiva with intraocular involvement. There was a marked infiltration of the choroid even behind the equator. No metastases were found. Conclusion: Advanced squamous cell carcinoma associated with superinfection may present as a primary inflammatory process. There may be extensive involvement of the choroid. Metastases are probably rare even in advanced cases of this type of carcinoma.

External-use and eye ofloxacin zinc preparation

Abstract: The present invention relates to a preparation for external application and ophthalmic application, in particular it is an ofloxacin preparation for curing the diseases of burn, scald, dermal infections, bed sore, eczema and bacterial conjunctivitis, coronitis, corneal ulcer, viral keratitis and preventing infection after operation of eye and promoting wound healing. The tests show that it possesses the obvious functions of resisting infection, astringing and promoting wound healing and promoting growth of corned epithelium.

Ultra-sonografia ocular em suspeita clínica de endoftalmite

Abstract: Purpose: To determine ultrasonographic findings in patients with clinical diagnosis of endophthalmitis, a severe purulent inflammatory reaction confined to the interior of the eye. Methods: Ultrasound examination was performed (10MHz transducer, UltraScan® ALCON), during the period of 1997 to 1999. Results: We analyzed 25 eyes with a clinical diagnosis of endophthalmitis (23 exogenous, 2 endogenous). Twelve (12/23) were post-surgery (7 post-cataract surgery, 4 post-glaucoma surgery and 1 post-keratoplasty). Six followed penetrating trauma and 4 were after corneal ulcer. One patient had corneal suture and cataract surgery after penetrating trauma. Two of them presented low-reflectivity echoes, similar to the normal vitreous, and endophthalmitis was ruled out at that time. Twenty-three cases presented (at different degrees) vitreous involvement with low-mobility dense membranes, vitreous organization and vitreous cavitation. Diffuse choroidal thickening (12 cases), choroidal and/or retinal detachment (8 and 5 cases) and orbital abscess (1 case) were found. Conclusions: Ultrasound examination is important to help in clinical suspected endophthalmitis in order to determine the involvement of the posterior segment.