Ocular Infection Prevention and Treatment Strategies

Ocular infections, particularly endophthalmitis, pose a significant threat to vision worldwide and demand a multifaceted approach encompassing prevention, rapid diagnosis and targeted therapy. Prevention strategies centre on strict aseptic protocols before, during and after intraocular procedures, including the use of antiseptic agents, optimised surgical techniques and judicious antibiotic prophylaxis. Emerging concerns about antimicrobial resistance and evolving pathogen spectra have stimulated the development of tailored perioperative regimens and risk-stratification tools. In parallel, advances in molecular diagnostics promise earlier and more precise pathogen identification, enabling clinicians to select effective intravitreal and systemic therapies. Treatment standards continue to rely on prompt intravitreal antibiotic administration and pars plana vitrectomy for severe cases, while systemic therapy remains essential for endogenous infections. Integration of genomics and next-generation sequencing into clinical workflows heralds a new era of personalised management, improving outcomes and informing global public health interventions.

Research from Nature Portfolio

Recent studies have demonstrated the power of genomics-based workflows to identify microbes in low-biomass ocular fluids. By employing curated microbial genome databases and rigorous filtering of host and contaminant sequences, these investigations achieved concordance with culture and mass spectrometry, detected antimicrobial resistance genes and characterised microbial sequence types. The resulting insights enabled more precise antibiotic selection and informed decisions on vitrectomy timing.

Subsequent proof-of-concept research employed unbiased next-generation sequencing on vitreous samples from culture-negative cases, revealing pathogens in the majority of presumed infections and mixed bacterial-fungal aetiologies undetected by conventional methods. High sensitivity and specificity against clinical diagnosis underscore the feasibility of NGS integration for rapid, actionable information in ocular infection management.

Ocular Infection Prevention and Treatment Strategies publication trend

The graph below shows the total number of articles in ocular infection prevention and treatment strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Endophthalmitis: Intraocular inflammation and infection of the vitreous and/or aqueous humours.

Intravitreal injection: Delivery of medication directly into the eye’s vitreous cavity.

Metagenomic sequencing: High-throughput analysis of genetic material to identify all microbial species in a sample.

Prophylactic antibiotic: Antibacterial agent administered to prevent infection before pathogen exposure.

References

1. Genomics-Based Identification of Microorganisms in Human Ocular Body Fluid. Scientific Reports (2018).
2. New insights into culture negative endophthalmitis by unbiased next generation sequencing. Scientific Reports (2019).
3. Endophthalmitis following intravitreal anti-vascular endothelial growth factor (VEGF) injection: a comprehensive review. International Journal of Retina and Vitreous (2015).
4. Microbial flora and resistance in ophthalmology: a review. Graefe's Archive for Clinical and Experimental Ophthalmology (2017).
5. Risk Factors for Acute Endophthalmitis following Cataract Surgery: A Systematic Review and Meta-Analysis. PLOS ONE (2013).
6. Endogenous endophthalmitis: diagnosis, management, and prognosis. Journal of Ophthalmic Inflammation and Infection (2015).