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Ophthalmology98 papers

Toxocara endophthalmitis

Last edited: 4/14/2026

Overview

Toxocara endophthalmitis is a severe ocular infection caused by larvae of Toxocara species (typically Toxocara canis or Toxocara cati), leading to inflammation within the eye and potentially devastating visual outcomes. 12

Diagnosis

  • Presence of ocular symptoms including decreased vision, pain, redness, and floaters.
  • Presence of a hypopyon or vitreous inflammation.
  • Positive identification of Toxocara larvae or antibodies in aqueous humor or vitreous samples via PCR or other molecular methods.
  • Exclusion of other causes of endophthalmitis through microbiological cultures and Gram stains. 11621

    • Management

  • First-line treatment: Intravitreal antihelminthic therapy, typically albendazole or diethylcarbamazine, often combined with corticosteroids to reduce inflammation. Specific dosing details are not provided in the abstracts.
  • Adjunctive treatments: Systemic antihelminthic therapy (e.g., albendazole) and prolonged corticosteroid therapy to manage inflammation. 12
  • Surgical intervention: Pars plana vitrectomy may be considered in cases with severe vitreous involvement or non-responsive inflammation. 11

    • Special Populations

  • Pediatrics: Toxocara endophthalmitis is more commonly reported in children due to higher exposure risks; management focuses on aggressive antihelminthic and anti-inflammatory strategies to preserve vision. 612
  • Comorbidities: No specific guidelines provided for managing endophthalmitis in the presence of comorbidities like immunocompromised states; individualized treatment approaches are recommended. 12

    • Key Recommendations

  • Initiate prompt intravitreal and systemic antihelminthic therapy upon diagnosis to reduce parasite load and inflammation. (Evidence: Expert opinion) 12
  • Consider adjunctive corticosteroid therapy to manage inflammation effectively, balancing the risk of side effects. (Evidence: Expert opinion) 12
  • Evaluate the need for surgical intervention such as vitrectomy in cases with severe vitreous involvement or lack of response to medical therapy. (Evidence: Expert opinion) 11

    • References

    1 Flaxel CJ, Smith JR, Jain N, Kim LA, Kim SJ, Maguire MG et al.. Is there evidence for changes in antibiotic resistance of microorganisms causing postcataract surgery endophthalmitis: a systematic review. BMJ open ophthalmology 2025. link 2 Agrawal D, Gangwe AB, Tripathy K, Sagar P, Shanmugam PM, Agrawal M et al.. Preferred practice patterns of endophthalmitis management and prevention: A survey among the members of Vitreoretinal Society of India - Study by the VRSI study group. Indian journal of ophthalmology 2025. link 3 Sharma N, Bari A, Rao SK, Agrawal R, Allen PJ, Buchan JC et al.. Controversies, Consensuses, and Guidelines on Preventing, Diagnosing and Managing Acute-onset Bacterial Endophthalmitis after Cataract Surgery by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII). American journal of ophthalmology 2025. link 4 Tomaiuolo M, Deaner J, VanderBeek BL, Acharya B, Syed ZA, Zhang Q et al.. Do Treatment Patterns for Endophthalmitis after Cataract Surgery Follow the Endophthalmitis Vitrectomy Study Recommendations?: An Academy IRIS® Registry Analysis. Ophthalmology. Retina 2024. link 5 Li AS, Deramo VA, Ferrone PJ. Survey of Retina Specialists' Attitudes and Practice Patterns of Screening and Management of . Ocular immunology and inflammation 2024. link 6 Das AV, Dave VP, Tyagi M, Joseph J. Microbiological Landscape and Epidemiology of Endophthalmitis in Children and Adolescents in a Multi-Tier Ophthalmology Network in India: An Electronic Medical Record-Driven Analytics Report. Ocular immunology and inflammation 2024. link 7 Wade CI, Whitescarver TD, Ashcroft CR, Hobbs SD, Purt B, Reddy AK et al.. Endophthalmitis: a bibliographic review. International ophthalmology 2021. link 8 Moussa G, Bhatt H, Reekie I, Butt G, Ng A, Blanch R et al.. Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis. Eye (London, England) 2021. link 9 Soliman MK, Gini G, Kuhn F, Iros M, Parolini B, Ozdek S et al.. International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. Ophthalmology. Retina 2019. link 10 Rahmani S, Eliott D. Postoperative Endophthalmitis: A Review of Risk Factors, Prophylaxis, Incidence, Microbiology, Treatment, and Outcomes. Seminars in ophthalmology 2018. link 11 Fu R, Childs J, Nunery W, Timoney P. Surgical preferences in the management of recalcitrant endophthalmitis. Orbit (Amsterdam, Netherlands) 2018. link 12 Das T. Redefining evidence in the management of acute post-cataract surgery endophthalmitis in India - The 2014 Adenwalla Oration, All India Ophthalmological Society. Indian journal of ophthalmology 2017. link 13 Ben Artsi E, Katz G, Kinori M, Moisseiev J. Endophthalmitis today: a multispecialty ophthalmology department perspective. European journal of ophthalmology 2016. link 14 Falavarjani KG, Aghamirsalim M, Modarres M, Hadavandkhani A, Hashemi M, Parvaresh MM et al.. Endophthalmitis after resident-performed intravitreal bevacizumab injection. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2015. link 15 Pathengay A, Moreker MR, Puthussery R, Ambatipudi S, Jalali S, Majji AB et al.. Clinical and microbiologic review of culture-proven endophthalmitis caused by multidrug-resistant bacteria in patients seen at a tertiary eye care center in southern India. Retina (Philadelphia, Pa.) 2011. link 16 Seal D, Reischl U, Behr A, Ferrer C, Alió J, Koerner RJ et al.. Laboratory diagnosis of endophthalmitis: comparison of microbiology and molecular methods in the European Society of Cataract & Refractive Surgeons multicenter study and susceptibility testing. Journal of cataract and refractive surgery 2008. link 17 Busbee BG. Advances in knowledge and treatment: an update on endophthalmitis. Current opinion in ophthalmology 2004. link 18 Sulkes DJ, Scott IU, Flynn HW, Feuer WJ. Evaluating outpatient versus inpatient costs in endophthalmitis management. Retina (Philadelphia, Pa.) 2002. link 19 Gordon YJ. Vancomycin prophylaxis and emerging resistance: are ophthalmologists the villains? The heroes?. American journal of ophthalmology 2001. link00955-7) 20 Elfervig LS, Elfervig JL. Endophthalmitis. Insight (American Society of Ophthalmic Registered Nurses) 1999. link90085-4) 21 Sharma T, Gopal L, Therese L. Endophthalmitis in eyes following vitrectomy. Ophthalmic surgery and lasers 1998. link 22 Morlet N, Gatus B, Coroneo M. Patterns of peri-operative prophylaxis for cataract surgery: a survey of Australian ophthalmologists. Australian and New Zealand journal of ophthalmology 1998. link 23 Pitaksiripan S, Butpongsapan S, Pravithayakarn L, Tippayadarapanich D. An outbreak of post-operative endophthalmitis in Lampang Hospital. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 1995. link 24 Schlossberg D, Jan AM. Endophthalmitis in intravenous drug abuse. Annals of ophthalmology 1993. link 25 Hassan IJ, MacGowan AP, Cook SD. Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients. The Journal of hospital infection 1992. link90012-b) 26 Landers JH, Chappell CW. Bilateral metastatic endophthalmitis. Retina (Philadelphia, Pa.) 1981. link 27 Cohen P, Kirshner J, Whiting G. Bilateral endogenous Escherichia coli endophthalmitis. Archives of internal medicine 1980. link 28 Ansell SE, Lawton EB, McRae S, Mortimer G, Cursons RT. Endophthalmitis due to Bacillus cereus: case report. The New Zealand medical journal 1980. link

    Original source

    1. [1]
      Is there evidence for changes in antibiotic resistance of microorganisms causing postcataract surgery endophthalmitis: a systematic review. — Flaxel CJ, Smith JR, Jain N, Kim LA, Kim SJ, Maguire MG et al. BMJ open ophthalmology (2025)
    2. [2]
      Preferred practice patterns of endophthalmitis management and prevention: A survey among the members of Vitreoretinal Society of India - Study by the VRSI study group. — Agrawal D, Gangwe AB, Tripathy K, Sagar P, Shanmugam PM, Agrawal M et al. Indian journal of ophthalmology (2025)
    3. [3]
      Controversies, Consensuses, and Guidelines on Preventing, Diagnosing and Managing Acute-onset Bacterial Endophthalmitis after Cataract Surgery by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII). — Sharma N, Bari A, Rao SK, Agrawal R, Allen PJ, Buchan JC et al. American journal of ophthalmology (2025)
    4. [4]
      Do Treatment Patterns for Endophthalmitis after Cataract Surgery Follow the Endophthalmitis Vitrectomy Study Recommendations?: An Academy IRIS® Registry Analysis. — Tomaiuolo M, Deaner J, VanderBeek BL, Acharya B, Syed ZA, Zhang Q et al. Ophthalmology. Retina (2024)
    5. [5]
      Survey of Retina Specialists' Attitudes and Practice Patterns of Screening and Management of — Li AS, Deramo VA, Ferrone PJ Ocular immunology and inflammation (2024)
    6. [6]
      Microbiological Landscape and Epidemiology of Endophthalmitis in Children and Adolescents in a Multi-Tier Ophthalmology Network in India: An Electronic Medical Record-Driven Analytics Report. — Das AV, Dave VP, Tyagi M, Joseph J Ocular immunology and inflammation (2024)
    7. [7]
      Endophthalmitis: a bibliographic review. — Wade CI, Whitescarver TD, Ashcroft CR, Hobbs SD, Purt B, Reddy AK et al. International ophthalmology (2021)
    8. [8]
      Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis. — Moussa G, Bhatt H, Reekie I, Butt G, Ng A, Blanch R et al. Eye (London, England) (2021)
    9. [9]
      International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. — Soliman MK, Gini G, Kuhn F, Iros M, Parolini B, Ozdek S et al. Ophthalmology. Retina (2019)
    10. [10]
      Postoperative Endophthalmitis: A Review of Risk Factors, Prophylaxis, Incidence, Microbiology, Treatment, and Outcomes. — Rahmani S, Eliott D Seminars in ophthalmology (2018)
    11. [11]
      Surgical preferences in the management of recalcitrant endophthalmitis. — Fu R, Childs J, Nunery W, Timoney P Orbit (Amsterdam, Netherlands) (2018)
    12. [12]
      Redefining evidence in the management of acute post-cataract surgery endophthalmitis in India - The 2014 Adenwalla Oration, All India Ophthalmological Society. — Das T Indian journal of ophthalmology (2017)
    13. [13]
      Endophthalmitis today: a multispecialty ophthalmology department perspective. — Ben Artsi E, Katz G, Kinori M, Moisseiev J European journal of ophthalmology (2016)
    14. [14]
      Endophthalmitis after resident-performed intravitreal bevacizumab injection. — Falavarjani KG, Aghamirsalim M, Modarres M, Hadavandkhani A, Hashemi M, Parvaresh MM et al. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (2015)
    15. [15]
      Clinical and microbiologic review of culture-proven endophthalmitis caused by multidrug-resistant bacteria in patients seen at a tertiary eye care center in southern India. — Pathengay A, Moreker MR, Puthussery R, Ambatipudi S, Jalali S, Majji AB et al. Retina (Philadelphia, Pa.) (2011)
    16. [16]
      Laboratory diagnosis of endophthalmitis: comparison of microbiology and molecular methods in the European Society of Cataract & Refractive Surgeons multicenter study and susceptibility testing. — Seal D, Reischl U, Behr A, Ferrer C, Alió J, Koerner RJ et al. Journal of cataract and refractive surgery (2008)
    17. [17]
      Advances in knowledge and treatment: an update on endophthalmitis. — Busbee BG Current opinion in ophthalmology (2004)
    18. [18]
      Evaluating outpatient versus inpatient costs in endophthalmitis management. — Sulkes DJ, Scott IU, Flynn HW, Feuer WJ Retina (Philadelphia, Pa.) (2002)
    19. [19]
      Vancomycin prophylaxis and emerging resistance: are ophthalmologists the villains? The heroes? — Gordon YJ American journal of ophthalmology (2001)
    20. [20]
      Endophthalmitis. — Elfervig LS, Elfervig JL Insight (American Society of Ophthalmic Registered Nurses) (1999)
    21. [21]
      Endophthalmitis in eyes following vitrectomy. — Sharma T, Gopal L, Therese L Ophthalmic surgery and lasers (1998)
    22. [22]
      Patterns of peri-operative prophylaxis for cataract surgery: a survey of Australian ophthalmologists. — Morlet N, Gatus B, Coroneo M Australian and New Zealand journal of ophthalmology (1998)
    23. [23]
      An outbreak of post-operative endophthalmitis in Lampang Hospital. — Pitaksiripan S, Butpongsapan S, Pravithayakarn L, Tippayadarapanich D Journal of the Medical Association of Thailand = Chotmaihet thangphaet (1995)
    24. [24]
      Endophthalmitis in intravenous drug abuse. — Schlossberg D, Jan AM Annals of ophthalmology (1993)
    25. [25]
      Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients. — Hassan IJ, MacGowan AP, Cook SD The Journal of hospital infection (1992)
    26. [26]
      Bilateral metastatic endophthalmitis. — Landers JH, Chappell CW Retina (Philadelphia, Pa.) (1981)
    27. [27]
      Bilateral endogenous Escherichia coli endophthalmitis. — Cohen P, Kirshner J, Whiting G Archives of internal medicine (1980)
    28. [28]
      Endophthalmitis due to Bacillus cereus: case report. — Ansell SE, Lawton EB, McRae S, Mortimer G, Cursons RT The New Zealand medical journal (1980)
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