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The authors of this study conducted a global survey of medical institutions regarding management of exogenous endophthalmitis to assess current practice patterns for this sight-threatening emergency. Thirty-six (of 42 institutions) responded and were included in the analysis. Results were as follows: (a) Method for obtaining cultures: 76% used vitreous tap, 24% vitrectomy and 21% anterior chamber tap; (b) Oral antibiotics were used in 58%, the commonest one being moxifloxacin; (c) Intravitreal antibiotics used were vancomycin and ceftazidime in 79%; (d) Intravitreal steroids were only routinely used in a third of respondents; (e) Indications for pars plana vitrectomy (PPV) varied significantly; in 39% of cases, decision regarding PPV was based on visual acuity (VA), the threshold being light perception in most, followed by hand movements and 6/60. Twelve percent of centres considered PPV in all cases of endophthalmitis or in cases not responding to intravitreal antibiotics or with no fundal view; (f) Admission to the hospital was required in 52%. The study highlights that global practice patterns in the management of exogenous endophthalmitis are highly variable, highlighting the need for further research into the areas of controversy in order to establish more evidence-based guidelines.

Global current practice patterns for the management of exogenous endophthalmitis: a survey by the American Society of Ophthalmic Trauma.
Wakabayashi T, Miller SC, Patel SN, et al.
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Kurt Spiteri Cornish

Sheffield Teaching Hospitals NHS Trust, London, UK.

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