Ophthalmology · Ocular Trauma and Emergencies (Chemical Burns, Open Globe, Endophthalmitis)

Endophthalmitis after cataract surgery presenting on day 2 post-op with severe pain, hypopyon, and 3+ vitreous cells on B-scan is MOST likely caused by:

  • A Propionibacterium (Cutibacterium) acnes
  • B Staphylococcus epidermidis
  • C Streptococcus species
  • D Fusarium solani
Correct answer: C. Streptococcus species

Explanation

Acute post-operative endophthalmitis presenting within 1–2 days of cataract surgery with virulent features (severe pain, corneal oedema, large hypopyon, dense vitritis) is most commonly caused by Streptococcus species (viridans streptococci or S. pneumoniae), which are among the most virulent organisms and produce the worst visual outcomes. Staphylococcus epidermidis is the most common causative organism overall but typically presents later (day 3–5) and is less fulminant. Cutibacterium acnes (formerly P. acnes) presents months later as chronic granulomatous endophthalmitis. Fusarium causes post-traumatic fungal endophthalmitis.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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