Below are some suggestions to prevent post-op endophthalmitis which fortunately is usually a rare complication.. The prognosis with acute endophthalmitis is usually quite poor so prevention is essence. Patients with endophthalmitis typically present with increasing ocular pain, decreasing vision, conjunctival injection, chemosis, lid edema / swelling, marked anterior chamber inflammation, corneal edema, hypopyon, and vitritis. Loss of red reflex with the fundus not visible is common. Oculr pain and hypopyon may be absent. Early diagnosis and treatment are essential. If in doubt refer ( telephone ) immediately.
#1. All pre-op and post-op directions should be given to patient and also the spouse and / or other family members.
#2. Patients should be told if possible to wash entire face thoroughly with soap and water the night before their surgery.
#3. Any topical ( eye ) medicine the patient is taking should be brought to the eye clinic the day of their surgery.
#4. The patient and the family should be instructed to leave the patch on the operated eye the night after the surgery. Do not remove patch.
#5. Wait 5 minutes between each drop. Shake well. Wash your hands thoroughly before applying any drops.
#6. The patient and their family should be told to not rub eye or eyelids post-op. Keep your fingers away from the eye / eyelids. Do not dab the eye with any rag or cloth. This is important.
#7. Any increased pain or loss of vision post-op is not normal. The patient should return ( call ) to eye clinic immediately.
#8. With diabetics, an attempt should be made to control glucose before and after cataract surgery. With uncontrolled diabetes, the patient is more at risk of problems post-op. Immunocompromised patients ( HIV+, etc. ) are at higher risk of endophthalmitis .
#9. Cataract surgery is an elective procedure. An attempt should be made to aid the patient in having their surgery but postponing the surgery is an option but only if truly indicated. If the surgery is cancelled then the patient may never have the cataract surgery .