The Endophthalmitis Vitrectomy Study (EVS) established that immediate vitrectomy is superior to vitreous tap and injection ONLY in which subset of post-cataract endophthalmitis patients?

• A All cases presenting within 6 weeks of surgery
• B Patients with counting fingers (CF) or better visual acuity
• C Patients with gram-positive organisms on smear
• D Patients with light perception only (LP) ✓

Explanation

The EVS (1995) showed that for post-cataract endophthalmitis, immediate pars plana vitrectomy was superior to vitreous tap only in patients with presenting visual acuity of light perception only (LP). In patients with hand movement (HM) or better acuity, vitrectomy and tap/injection were equivalent. All patients should receive systemic antibiotics per EVS (though this conclusion was controversial later). The distinction in visual acuity at presentation (LP vs HM/better) remains the key clinical decision point from the EVS.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.