HMN 2026: which eye infections pose greatest threat to vision

Eye surgery today is safer than ever, yet ophthalmologists must remain watchful for a rare but serious complication that can threaten sight within days: a bacterial eye infection called endophthalmitis. Now, clinician-scientists at the University of Utah’s John A. Moran Eye Center have identified which types of endophthalmitis pose the greatest danger—findings that could help deliver faster, more personalized treatment to improve a patient’s chances of recovery.

Moran researchers Christopher Conrady, Akbar Shakoor and Albert T. Vitale were on a team that analyzed more than 240 cases of endophthalmitis treated between 2012 and 2022 at four academic medical centers. The group discovered that the type of bacteria causing the infection strongly influenced whether patients regained vision or developed serious complications.

Ophthalmologists treating endophthalmitis have largely based treatment decisions on a patient’s visual acuity at the time of diagnosis. Published in the American Journal of Ophthalmology, the new findings point to another factor that may be just as important: understanding exactly which organism is causing the infection.

That shift could eventually help ophthalmologists make faster, more individualized decisions about when patients may need antibiotic injections or surgery to help clear the infection.

Some bacteria caused relatively mild disease, while others triggered rapid and devastating damage inside the eye.

“Not all infections behave the same way,” said Conrady, an infectious eye disease specialist who led the research project. “Our findings suggest we may need to identify the most dangerous infections faster so we can intervene earlier and better protect patients’ vision.”

The study found patients infected with more aggressive bacteria—including certain Streptococcus and Enterococcus species—were far more likely to experience severe vision loss and complications than patients infected with more common surface bacteria.

Conrady said the findings highlight challenges that have slowed clinical advances in endophthalmitis care, much of which is still guided by a landmark 1996 study. In a newly published editorial in the journal Ophthalmology, he discusses the need for faster diagnostic tools to help doctors identify dangerous bacteria sooner, as well as additional studies to better understand which treatment approaches work best for different types of infection.

“This is about making excellent care even better,” Conrady said. “We want to give patients the best possible chance of preserving vision if these infections occur.”

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