Although uncommon (1:10000 cataract cases) infective endophthalmitis should be suspected in any post-operative patients presenting with pain +/- reduced vision. This occurs most commonly within the first post-operative week. All post-cataract patients in our department are advised to contact us directly should pain or reduced vision occurs. 

Presentation:

• Painful red eye following recent cataract extraction (usually within the first week)
• Reduced vision.

• Visual acuity is reduced.
• Injection of the conjunctiva +/- swollen lids
• Hypopyon (pus in the anterior chamber may be visible with naked eye)

• Refers the patient as soon as possible for exclusion of endophthalmitis
• If endophthalmitis were present or suspected, the patient is admitted and 

treated with vitreous tap for culture and sensitivity and intravitreal antibiotics injection.

Figure 1. The picture shows the presence of pus in the anterior chamber (hypopyon). This  should be treated as infective endophthalmitis in any patients who recently had a  cataract extraction. The treatment involves admission  for vitreous tap for culture  and sensitivity and given intravitreous amikacin and vancomycin.

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