William Atkins1, Rosie Dawkins1,2, Penelope Allen1,2

Purpose: To compare and contrast endophthalmitis cases from 1997- 2002 with those observed during the years 2012 – 2017 at the Royal Victorian Eye and Ear Hospital (RVEEH), Melbourne, Victoria to iden- tify trends in disease causation and incidence.
Methods: The Victorian Endophthalmitis Registry has been maintained by the authors (RD and PJA) for twenty years, and prospectively collects all cases of endophthalmitis presenting to the RVEEH. The registry records all endophthalmitis cases presenting in Victoria. To understand how endophthalmitis has changed over this time, we primarily focused on comparing the two eras to understand the reasons for variations in endophthalmitis between the periods. Data has been collected on patient demo- graphics, risk factors, causative events and culture results.
Results: Case numbers remained stable between the two periods of 1/7/1997-30/6/2002 and 1/7/2012 – 30/6/2017. In 1997-2002 the most com- mon precipitating event was cataract surgery (61.1%), however between 2012-2017 this changed to intravitreal injections (38.6%). Endophthalmitis following glaucoma surgery at 13-14% of case load has remained a constant issue and from endogenous disease has increased in incidence from 6.7% to 12.0%. There has also been an increase in the pro- portion of cases resulting from more aggressive gram-positive microorganisms (22-32%).
Conclusions: Endophthalmitis remains a rare but serious complication of eye surgery, eye trauma and septicaemia. However the causative events have altered with prophylaxis for cataract surgery and penetrating injury, and the advent of intravitreal injections in common practice. The burden of dis- ease due to glaucoma surgery seems constant and severe.