EyeWorld India March 2019 Issue
32 March 2019 EWAP CATARACT / IOL Adelman. If not treated quickly, endophthalmitis can damage the retina and result in poor vision, so it’s safer to assume the patient has endophthalmitis and treat it first as an infection, he said. Treat the patient with antibiotics and move on to steroid treatment if symptoms don’t resolve. When treating a patient for TASS, the primary goal is to suppress the subsequent inflammatory response to toxic insult, Dr. Adelman said. Apply topical prednisolone acetate 1% every 1–2 hours and monitor the patient closely, even a few hours after starting treatment, to ensure the inflammation and corneal edema are not worsening, he said. The bottom line is if you’re at all suspicious that the patient’s symptoms are endophthalmitis, do not delay treatment, Dr. Adelman said. Because endophthalmitis can be vision-threatening, physicians can’t risk not treating it, he said. “Any time I think that it may be endophthalmitis, I’ll treat it as endophthalmitis,” Dr. Adelman said. “I’ll inject antibiotics, and we can start steroids, too. That way at least we have covered the one that can cause significant damage to the retina and intraocular tissues.” EWAP Editors’ note: Dr. Adelman and Dr. Charles have no financial interests related to their comments. Dr. Olsen has financial interests with iMacular Regeneration (Rochester, Minnesota). Contact information Adelman: ron.adelman@yale.edu Charles: scharles@att.net Olsen: tolsen@emory.edu Distinguishing TASS - from page 31
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