To investigate the impact of time from symptom onset to presentation on the clinical course and outcomes of eyes with endophthalmitis.
Retrospective longitudinal cohort study.
One hundred and thirty-three eyes of 130 patients with endophthalmitis.
Adults diagnosed with endophthalmitis at the Duke Eye Center from January 1, 2009 to January 1, 2018 were identified utilizing Duke Enterprise Data Unified Content Explorer (DEDUCE). Patient demographics, time of symptom onset, presenting clinical features, management, and outcomes were recorded by retrospective review. Patients were divided into those presenting to medical care either early (within 2 days) or later (delayed, 3 days or longer) with regard to symptom onset. Clinical features, management, and visual outcomes of eyes with early or delayed presentation were compared.
Mean corrected visual acuity (VA) at presentation and at 6 months.
In eyes with delayed presentation, VA was significantly worse on initial exam (delayed 20/2941 vs early 20/1124, p = 0.009) and at 6 months (delayed 20/547 vs early 20/173, p = 0.01). When controlling for time to presentation, pre-endophthalmitis VA was significantly correlated with VA at 6 months (Pearson r = 0.55, R = 29%, p 0.05).
Delayed presentation was associated with worse VA on initial exam and at 6 months in eyes with endophthalmitis. Presence of pain did not prompt earlier presentation. Pre-endophthalmitis VA was associated with VA at 6 months, regardless of time to presentation. Further investigation may help improve anticipatory guidelines for at-risk patients.

Copyright © 2020. Published by Elsevier Inc.