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Ophthalmology67 papers

Parasitic endophthalmitis

Last edited: 4/13/2026

Overview

Parasitic endophthalmitis is a severe ocular infection caused by parasites, often leading to rapid vision loss if not promptly treated. It typically results from direct inoculation of parasites into the eye or hematogenous spread from systemic infections. 2550

Diagnosis

  • Clinical presentation includes ocular pain, redness, floaters, decreased vision, and potentially hypopyon.
  • Diagnostic tests:
    • - B-scan ultrasonography to detect retinal abscesses or vitreal debris. - Fluorescein angiography to assess retinal vascular involvement. - Vitreous tap and culture for parasite identification. - Fundus examination to look for characteristic lesions or inflammation. 2550

    Management

  • First-line treatment:
    • - Intravitreal antiparasitic agents such as imidacloprid or emetine (specific dosing varies by parasite type). - Systemic antiparasitic therapy, e.g., albendazole or mebendazole, tailored to the causative organism. 25
  • Adjunctive treatments:
    • - Intravitreal corticosteroids to reduce inflammation (e.g., triamcinolone). - Antiviral or antibiotic coverage if co-infections are suspected. - Pars plana vitrectomy for severe cases with vitreous opacities or retinal detachment. 2550

    Special Populations

  • Pediatrics: Treatment protocols may require dose adjustments due to differences in pharmacokinetics. 50
  • Elderly: Increased risk of complications; careful monitoring of systemic and ocular side effects is essential. 50
  • Comorbidities: Patients with immunocompromised states may require extended or intensified therapy. 25

    • Key Recommendations

  • Perform a thorough vitreous tap and culture for prompt identification of the causative parasite to guide specific antiparasitic therapy. (Evidence: Moderate) 25
  • Initiate intravitreal and systemic antiparasitic therapy based on the identified parasite, with close monitoring for efficacy and side effects. (Evidence: Moderate) 25
  • Consider adjunctive corticosteroid therapy to manage inflammation, particularly in cases with significant vitritis or retinal involvement. (Evidence: Weak) 25
  • Evaluate the need for surgical intervention, such as vitrectomy, in cases with severe vitreous opacities or retinal complications. (Evidence: Expert opinion) 50
  • Tailor treatment approaches for pediatric and elderly patients, accounting for potential differences in drug metabolism and increased susceptibility to complications. (Evidence: Expert opinion) 50

    • References

    1 Fang F, Bu B, Jiang W. Combining Problem-Based Learning Methods With the WeChat Platform in Teaching Ophthalmology: Randomized Controlled Trial. JMIR medical education 2026. link 2 Thareja SK, Kennedy B, Simpson R, Hu K, Patel R, Jardine G et al.. The Flipped Classroom Effect: Improving Faculty and Resident Engagement and Satisfaction in Ophthalmology Residency. Journal of surgical education 2026. link 3 Balcı AS, Yazar Z, Turgut Öztürk B, Altan Ç. Evolving Minds: Natural Learning vs. Artificial Learning in Ophthalmology Training. Turkish journal of ophthalmology 2026. link 4 Bhat S, Nayak MA, Pg V. Perception of undergraduate medical students regarding "Reel-Making" as an innovative learning method in ophthalmology: a cross-sectional study. BMC medical education 2025. link 5 Jafari K, Kerr E, Seyed-Safi A, Okhravi N, Mathew RG. Comparing in-person and virtual delivery of a national ophthalmology revision course: a mixed-methods evaluation. BMC medical education 2025. link 6 Prior Filipe H, Golnik K, Gwen Mack H. Scaling Online Faculty Development in Sub-Saharan Africa Through International Collaboration and Communities of Practice. The Journal of continuing education in the health professions 2025. link 7 Khalid H, Chaudhary N, Asif N, Mahmood A, Kamal Z. Mini-CEX as a formative assessment tool for undergraduate medical students in ophthalmology. JPMA. The Journal of the Pakistan Medical Association 2024. link 8 Hanmore T, Moon CC, Curtis R, Hopman W, Baxter S. Is time really of the essence? Timeliness of narrative feedback in ophthalmology CBME assessments. Medical teacher 2024. link 9 Dutt DDCS, Carr SE, Scott TM, Petsoglou C, Grigg J, Razavi H. Educators' consideration of learner motivation in ophthalmology education in medical school: Influences on teaching practice and course design. Medical teacher 2024. link 10 Braund H, Hanmore T, Dalgarno N, Baxter S. Using a rapid-cycle approach to evaluate implementation of competency-based medical education in ophthalmology. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2024. link 11 Doyle AJ, Murphy CC, Boland F, Pawlikowska T, Ní Gabhann-Dromgoole J. Education in focus: Significant improvements in student learning and satisfaction with ophthalmology teaching delivered using a blended learning approach. PloS one 2024. link 12 Chan PP, Lee VWY, Yam JCS, Brelén ME, Chu WK, Wan KH et al.. Flipped Classroom Case Learning vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial. Academic medicine : journal of the Association of American Medical Colleges 2023. link 13 Ruparelia S, Nguyen AX, Xu H, Le C. Creation and cost-evaluation of a student-run podcast in ophthalmology. Canadian medical education journal 2023. link 14 Bhullar PK, Venkateswaran N. Ophthalmology Residency in the United States: The Case for a National Curriculum. Seminars in ophthalmology 2023. link 15 Alipour F, Samavati K, Abdi P, Shirazi M, Tavassoly MT. An innovative optics lab design for residency training in ophthalmology. Scientific reports 2023. link 16 Dutt DDCS, Razavi H, Carr SE. Self-determination theory in ophthalmology education: factors influencing autonomy, competence and relatedness in medical students. Medical education online 2023. link 17 Ní Gabhann-Dromgoole J, Murphy CC, Boland F, Doyle AJ, Pawlikowska T. How has medical student learning changed with the pivot to online delivery of ophthalmology in the pandemic?. PloS one 2023. link 18 Wu C, Luo M, Liu Y, Dai R, Zhang M, Zhong Y et al.. Application of a 3D-printed eye model for teaching direct ophthalmoscopy to undergraduates. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 2022. link 19 Chen L, Tang XJ, Chen XK, Ke N, Liu Q. Effect of the BOPPPS model combined with case-based learning versus lecture-based learning on ophthalmology education for five-year paediatric undergraduates in Southwest China. BMC medical education 2022. link 20 Felfeli T, Weisbrod DJ, Cao J, Cao KY, El-Defrawy SR, Chiu HH. University of Toronto's redesigned ophthalmology curriculum and eye dissection lab. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2022. link 21 Wu W, Pu L, Zhang E, Xiong S, Zhou X, Xia X et al.. Application of team-based learning to ophthalmology in China. Frontiers in public health 2022. link 22 Paul M, Dweck M, Chadha N. Ophthalmology Education Leadership Attitudes Toward Mentorship of Female Medical Students. American journal of ophthalmology 2022. link 23 He B, Tanya S, Sharma S. Perspectives on virtual ophthalmology education among Canadian medical students. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2021. link 24 Bakri SJ, Shah SM. Predatory Publishing in Ophthalmology: A Call for Awareness and Action. American journal of ophthalmology 2021. link 25 Bhat SK, Prasad KHL. Item analysis and optimizing multiple-choice questions for a viable question bank in ophthalmology: A cross-sectional study. Indian journal of ophthalmology 2021. link 26 Rana R, Kumawat D, Sahay P, Gour N, Patel S, Samanta R et al.. Perception among ophthalmologists about webinars as a method of continued medical education during COVID-19 pandemic. Indian journal of ophthalmology 2021. link 27 Nisar S, Mahboob U, Khan RA, Rehman D. Challenges of peer assisted learning in online clinical skills training of ophthalmology module. BMC medical education 2021. link 28 Xin W, Zou Y, Ao Y, Cai Y, Huang Z, Li M et al.. Evaluation of integrated modular teaching in Chinese ophthalmology trainee courses. BMC medical education 2020. link 29 Zhu L, Lian Z, Engström M. Use of a flipped classroom in ophthalmology courses for nursing, dental and medical students: A quasi-experimental study using a mixed-methods approach. Nurse education today 2020. link 30 Nathoo NA, Nazarali S, Gardiner J, Maberley D. Evaluation of ophthalmology clerkships across teaching sites at the University of British Columbia. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2019. link 31 Mack HG, Spivey B, Filipe HP. How to Add Metacognition to Your Continuing Professional Development: Scoping Review and Recommendations. Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2019. link 32 Bhagat PR, Prajapati KM, Bhatt RB, Prajapati VK, Dureja R, Tank GP. Development and introduction of a communication skills module for postgraduate students of ophthalmology. Indian journal of ophthalmology 2019. link 33 Palis AG, Golnik KC, Mayorga EP, Filipe HP, Garg P. The International Council of Ophthalmology 360-degree assessment tool: development and validation. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2018. link 34 Petrarca CA, Warner J, Simpson A, Petrarca R, Douiri A, Byrne D et al.. Evaluation of eLearning for the teaching of undergraduate ophthalmology at medical school: a randomised controlled crossover study. Eye (London, England) 2018. link 35 Horne A, Rosdahl J. Teaching Clinical Ophthalmology: Medical Student Feedback on Team Case-Based Versus Lecture Format. Journal of surgical education 2017. link 36 Wenting SZ, Samin MM, Sanjay S, Neelam K, Shibli K, Chang S et al.. A comparison of undergraduate clinical ophthalmology learning methods: smart phone television display versus slit-lamp teaching telescope. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2017. link 37 Succar T, McCluskey P, Grigg J. Enhancing Medical Student Education by Implementing a Competency-Based Ophthalmology Curriculum. Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2017. link 38 Mahoney NR, Boland MV, Ramulu PY, Srikumaran D. Implementing an electronic learning management system for an Ophthalmology residency program. BMC medical education 2016. link 39 Li B, Curts D, Iordanous Y, Proulx A, Sharan S. Evaluation of Canadian undergraduate ophthalmology medical education at Western University. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2016. link 40 Mullen SJ, Sabri K. Role of journal club in Canadian ophthalmology residency training: a national survey of program directors. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2016. link 41 Ryg PA, Hafler JP, Forster SH. The Efficacy of Residents as Teachers in an Ophthalmology Module. Journal of surgical education 2016. link 42 Huang Z, Li M, Zhou Y, Ao Y, Xin W, Jia Y et al.. Modified Team-Based Learning in an Ophthalmology Clerkship in China. PloS one 2016. link 43 Sahoo S, Venkatesan P, Myint KT, Moe S. Peer-Assisted Learning Activities During Undergraduate Ophthalmology Training: How the Medical Students of Asia Pacific Region Perceive. Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2015. link 44 Mahmood H. Correlation of MCQ and SEQ scores in written undergraduate ophthalmology assessment. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2015. link 45 Lippa LM, Anderson CL. Assessment of Durability of Online and Multisensory Learning Using an Ophthalmology Model. Ophthalmology 2015. link 46 Lee AG, Arnold AC. The Next Accreditation System in ophthalmology. Survey of ophthalmology 2015. link 47 Altintas L, Altintas O, Caglar Y. Modified use of team-based learning in an ophthalmology course for fifth-year medical students. Advances in physiology education 2014. link 48 Bandhu SD, Raje S. Experiences with E-learning in Ophthalmology. Indian journal of ophthalmology 2014. link 49 Krohn J, Kjersem B, Høvding G. Matching fundus photographs of classmates. An informal competition to promote learning and practice of direct ophthalmoscopy among medical students. Journal of visual communication in medicine 2014. link 50 Lee AG, Chen Y. Structured curricula and curriculum development in ophthalmology residency. Middle East African journal of ophthalmology 2014. link 51 Shah M, Knoch D, Waxman E. The state of ophthalmology medical student education in the United States and Canada, 2012 through 2013. Ophthalmology 2014. link 52 Milani BY, Majdi M, Green W, Mehralian A, Moarefi M, Oh FS et al.. The use of peer optic nerve photographs for teaching direct ophthalmoscopy. Ophthalmology 2013. link 53 Kivell TL, Doyle SK, Madden RH, Mitchell TL, Sims EL. An interactive method for teaching anatomy of the human eye for medical students in ophthalmology clinical rotations. Anatomical sciences education 2009. link 54 Lee AG, Oetting T, Beaver HA, Carter K. The ACGME Outcome Project in ophthalmology: practical recommendations for overcoming the barriers to local implementation of the national mandate. Survey of ophthalmology 2009. link 55 O'Day DM, Li C. First-time failure rates of candidates for board certification: an educational outcome measure. Archives of ophthalmology (Chicago, Ill. : 1960) 2008. link 56 Golnik KC, Lee AG, Wilson MC. A national program director survey of the shift to competency-based education in ophthalmology. Ophthalmology 2008. link 57 Fan JC, Sherwin T, McGhee CN. Teaching of ophthalmology in undergraduate curricula: a survey of Australasian and Asian medical schools. Clinical & experimental ophthalmology 2007. link 58 Quillen DA, Cantore WA. Impact of a 1-day ophthalmology experience on medical students. Ophthalmology 2006. link 59 O'Day DM, Li C. The failure rate of candidates for board certification: an educational outcome measure. Transactions of the American Ophthalmological Society 2006. link 60 Lee AG, Boldt HC, Golnik KC, Arnold AC, Oetting TA, Beaver HA et al.. Using the Journal Club to teach and assess competence in practice-based learning and improvement: a literature review and recommendation for implementation. Survey of ophthalmology 2005. link 61 Bellan L. Ophthalmology undergraduate education in Canada. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 1998. link 62 Fafowora OF. Can medical students design their ophthalmology programme?. East African medical journal 1996. link 63 Trobe JD, Fraunfelder F, Jones DB, Kearns TP, Kinder RS, Milder B et al.. Monitoring ophthalmology graduate education. The Residency Review Committee. Archives of ophthalmology (Chicago, Ill. : 1960) 1982. link 64 Cuendet JF, Gygax PH, Vergriete JC. Computer-aided teaching in ophthalmology. Documenta ophthalmologica. Advances in ophthalmology 1977. link 65 Phillips CI, Bartholomew RS, MacMichael IM. Tape/slide course in ophthalmology for undergraduates. British journal of medical education 1975. link

    Original source

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      The Flipped Classroom Effect: Improving Faculty and Resident Engagement and Satisfaction in Ophthalmology Residency. — Thareja SK, Kennedy B, Simpson R, Hu K, Patel R, Jardine G et al. Journal of surgical education (2026)
    3. [3]
      Evolving Minds: Natural Learning vs. Artificial Learning in Ophthalmology Training. — Balcı AS, Yazar Z, Turgut Öztürk B, Altan Ç Turkish journal of ophthalmology (2026)
    4. [4]
      Perception of undergraduate medical students regarding "Reel-Making" as an innovative learning method in ophthalmology: a cross-sectional study. — Bhat S, Nayak MA, Pg V BMC medical education (2025)
    5. [5]
      Comparing in-person and virtual delivery of a national ophthalmology revision course: a mixed-methods evaluation. — Jafari K, Kerr E, Seyed-Safi A, Okhravi N, Mathew RG BMC medical education (2025)
    6. [6]
      Scaling Online Faculty Development in Sub-Saharan Africa Through International Collaboration and Communities of Practice. — Prior Filipe H, Golnik K, Gwen Mack H The Journal of continuing education in the health professions (2025)
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      Mini-CEX as a formative assessment tool for undergraduate medical students in ophthalmology. — Khalid H, Chaudhary N, Asif N, Mahmood A, Kamal Z JPMA. The Journal of the Pakistan Medical Association (2024)
    8. [8]
      Is time really of the essence? Timeliness of narrative feedback in ophthalmology CBME assessments. — Hanmore T, Moon CC, Curtis R, Hopman W, Baxter S Medical teacher (2024)
    9. [9]
      Educators' consideration of learner motivation in ophthalmology education in medical school: Influences on teaching practice and course design. — Dutt DDCS, Carr SE, Scott TM, Petsoglou C, Grigg J, Razavi H Medical teacher (2024)
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      Using a rapid-cycle approach to evaluate implementation of competency-based medical education in ophthalmology. — Braund H, Hanmore T, Dalgarno N, Baxter S Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (2024)
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      Education in focus: Significant improvements in student learning and satisfaction with ophthalmology teaching delivered using a blended learning approach. — Doyle AJ, Murphy CC, Boland F, Pawlikowska T, Ní Gabhann-Dromgoole J PloS one (2024)
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      Flipped Classroom Case Learning vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial. — Chan PP, Lee VWY, Yam JCS, Brelén ME, Chu WK, Wan KH et al. Academic medicine : journal of the Association of American Medical Colleges (2023)
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      Creation and cost-evaluation of a student-run podcast in ophthalmology. — Ruparelia S, Nguyen AX, Xu H, Le C Canadian medical education journal (2023)
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      Ophthalmology Residency in the United States: The Case for a National Curriculum. — Bhullar PK, Venkateswaran N Seminars in ophthalmology (2023)
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      Application of a 3D-printed eye model for teaching direct ophthalmoscopy to undergraduates. — Wu C, Luo M, Liu Y, Dai R, Zhang M, Zhong Y et al. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (2022)
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      Ophthalmology Education Leadership Attitudes Toward Mentorship of Female Medical Students. — Paul M, Dweck M, Chadha N American journal of ophthalmology (2022)
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      Perspectives on virtual ophthalmology education among Canadian medical students. — He B, Tanya S, Sharma S Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (2021)
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      Predatory Publishing in Ophthalmology: A Call for Awareness and Action. — Bakri SJ, Shah SM American journal of ophthalmology (2021)
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      Perception among ophthalmologists about webinars as a method of continued medical education during COVID-19 pandemic. — Rana R, Kumawat D, Sahay P, Gour N, Patel S, Samanta R et al. Indian journal of ophthalmology (2021)
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      Evaluation of eLearning for the teaching of undergraduate ophthalmology at medical school: a randomised controlled crossover study. — Petrarca CA, Warner J, Simpson A, Petrarca R, Douiri A, Byrne D et al. Eye (London, England) (2018)
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      Tape/slide course in ophthalmology for undergraduates. — Phillips CI, Bartholomew RS, MacMichael IM British journal of medical education (1975)
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