Evaluation and Recognition

The examination is carried out in the usual manner (see Chap. 1.9). If an open globe injury is found (see Chap. 2.11), the possibility of endophthalmitis development should always be on high the ophthalmologist's list.

Fig. 2.17.1 Macular hypopyon in endophthalmitis. This intraoperative photograph1 shows a severe accumulation of pus over the macula. A fibrinous membrane can form on top of the pus, making its appearance similar to that of a cyst. The membrane may have to incised before careful passive aspiration can remove the pus entirely or at least reduce its amount. If the pus is not extracted, there is little hope for recovering useful macular vision. Use of TPA (see Chap. 2.9) greatly aids in detaiching the fibrinpus complex from the macular surface.

Fig. 2.17.1 Macular hypopyon in endophthalmitis. This intraoperative photograph1 shows a severe accumulation of pus over the macula. A fibrinous membrane can form on top of the pus, making its appearance similar to that of a cyst. The membrane may have to incised before careful passive aspiration can remove the pus entirely or at least reduce its amount. If the pus is not extracted, there is little hope for recovering useful macular vision. Use of TPA (see Chap. 2.9) greatly aids in detaiching the fibrinpus complex from the macular surface.

1 The light pipe is visible in the lower left corner.

Specific questions during history-taking should be directed toward determining whether the injury was of average or increased risk.

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