• Conversely, a positive culture is not synonymous with the diagnosis of endophthalmitis: IOFBs have routinely been cultured positive without the development of an infection [11].

• The traditional staging of endophthalmitis ("mild" vs "severe") does not force the ophthalmologist to appreciate the infection as a continuum. In a real-life scenario it is counterproductive to artificially classify an ongoing infection as "mild" as if the process could not rapidly turn into a "severe" one.

• Endophthalmitis should be classified as early if there is minimal anterior segment involvement and the red reflex is preserved.

• Endophthalmitis should be classified as advanced if the infection caused significant anterior segment or vitreoretinal pathologies [12].

• A macular hypopyon (Fig. 2.17.1) is often present in an eye with endophthalmitis. In this condition pus settles on the macula [12]. Such a macular pathology explains why only half of the eyes regained 20/40 or greater vision in the EVS [6] and why it is so important to create a PVD during vitrectomy [10]. Complete vitreous removal is especially crucial if the endophthalmitis is trauma related (see below).

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