One of the most acute and serious problems to develop is endophthalmitis or infection within the eye. Fortunately, endophthalmitis rarely occurs in more than one in 1,000 to one in 500 cataract cases. If you have progressive redness, pain, or loss of vision after surgery you should notify your surgeon immediately. Infections typically arise from bacteria which normally reside on the skin and mucous membranes around the eye. There is inflammation after any type of eye surgery; however inflammation associated with bacterial infection requires urgent treatment.

Depending on the severity of infection this may require treatment in the office or in the operating room. A small amount of fluid is removed from the eye which is used to identify the bacteria, and to determine its sensitivity to a variety of antibiotics. A bacteria can be identified in about 2/3 of the cases. Once a sample is removed one or more broad spectrum antibiotics are injected into the eye which eradicates 99 percent of known bacteria. You can expect at least three to four weeks before any significant improvement in vision. Depending on the severity of infection this may require treatment in the office or in the operating room.

In more severe cases, an operation called a vitrectomy is necessary to remove the pus from the jelly filled central cavity of the eye. At the time of surgery samples of eye fluid are sent to the laboratory and antiobiotics are injected into the eye.

There are other rare forms of inflammation in the eye which can also develop weeks to months after a cataract operation. Some cases are caused by a smoldering chronic bacterial or fungal infection. Other cases of post-operative inflammation are not related to an infection by a bacteria or fungus and often require further investigation. If either an acute or chronic endophthalmitis is suspected, your ophthalmologist will discuss treatment options with you.