00:00
That's the lens and cataracts. Let's look at diseases or primarily infection of the vitreous
body. Endophthalmitis is inflammation of the vitreous humor and actually it's just an
inflammation, maybe infectious or it can be non-infectious and sterile. What are the signs
and symptoms? There will be pain in general. When there is inflammation, there will be pain.
00:28
As inflammation involves the other structures of the eye such as the conjunctiva and/or the
lacrimal gland, we will get increased tearing, that's all part and parcel of the inflammatory
process. The redness there is because of inflammation that has extended on to the
conjunctiva. There will be photophobia. Because of the inflammation, we will tend to have
pupillary dilation, mydriasis. And when we do that, you go into a bright room and it makes you
wince because your pupils cannot rapidly contract as they should. And with all that edema
throughout the eye, you're going to have an abnormal vision, you're going to have blurring
because of the edema. Swollen eyelids, this is a blepharitis that is secondary to infection
of the vitreous body. And you're going to have other changes, corneal edema. So the cornea
will become inflamed, will have increased fluid within it, as you can see the red eye the
congestion of the conjunctiva. And hypopyon, "Oh my goodness" pus, that little rim of
yellowness at the base of the iris is pus in the anterior chamber. And that's, again,
inflammatory cells that are crawling out in response to the ongoing inflammation, infectious
or otherwise. What do we do about it or how do we get there? Intraocular surgery. You can
have penetrating injury, so something gets stuck in your eye, obviously it may carry in
with infectious organisms. Other intraocular infections, so something that may start as a
superficial corneal ulcer and infection may eventually progress depending on the virulence
of the pathogen into the vitreous. You can also have systemic seeding. So if bacteria or
other pathogenic agents are in the bloodstream, they can just luckily draw, set up shop
within the vitreous and we have endophthalmitis. What does it look like in fundoscopic exam?
Basically, you're seeing lesions where you're getting deposits of neutrophils. It's an
inflammatory response. The vasculature may be very prominent, you may have edema as
well. This is just an example of fungal endophthalmitis and we have neutrophils and fungus
back there on the retina. And with that, we've covered cataracts and inflammation of the
vitreous body.