Endogenous endophthalmitis is an infection of the eye, caused by a bacteria or fungus. In many instances, by the time it is diagnosed and treated the condition has escalated to emergency status with severe sight-threatening complications. It is often a diagnostic challenge because
Endogenous endophthalmitis can affect people of all ages and is associated with a number of underlying factors. The infection is less common in young children, and diagnosis in children can be delayed in the paediatric cases due to their inability to report symptoms early.
Endogenous endophthalmitis is treated by a vitro-retinal surgeon, who has been trained to diagnose retinal and vitreous diseases through a detailed eye examination, using highly technical equipment and testing.
In February 2023, Dr Long treated 2-year-old Itay Sin, at KSFH. Dr Long diagnosed Itay Sin with endogenous endophthalmitis. Normally a happy and playful child, Itay Sin’s right eye had become red, he had a fever and was unsettled day and night. The infection had progressed to a dangerous point.
Itay Sin’s mother Veng Bopa initially sought help from local health care providers. Hailing from a small village more than 150kms south of Phenom Penh, the family became distressed when Itay Sin’s symptoms began to worsen.
Call it a parent’s intuition or a gut feeling, but Veng Bopa knew something was seriously wrong. “I was so worried about my son and the pain he was feeling in his eyes. My heart twisted every time he cried. I was concerned about the damage being permanent, and I didn’t know who could help him.”
Itay Sin finally received a referral to see Dr Long. At 3am the next day, using money borrowed from friends and family, Veng Bopa travelled via tuk tuk with her distressed son. The journey took 5 hours.
Luckily, Dr Long was trained and ready to help Itay Sin. He diagnosed him with Endogenous endophthalmitis, an infection of the eye that had progressed to a dangerous point. The infant was treated under general anaesthetic, and required vitro-retina surgery and injections in his eye. Dr Long assessed the front and back of the eye for vision loss and also checked the child’s left eye. Within 24 hours of treatment, Itay Sin smiled again. With his pain reduced, he was finally able to sleep.
His treatment continued with antibiotics until Dr Long was able to assess Itay Sin’s vision. Making the long journey back to KSFH a week later, Dr Long confirmed that Itay Sin’s sight had been seriously impacted by the infection. His significant vision loss was permanent.
The heartbreaking fact is this could have been avoided if Itay Sin had access to specialised retinal care and treatment, closer to home.
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