American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary treatment option for endophthalmitis?

1. Oral antibiotics

2. Intravitreal antibiotics

3. Topical steroid drops

4. Laser therapy

The correct answer is: Intravitreal antibiotics

The primary treatment option for endophthalmitis is intravitreal antibiotics. Endophthalmitis is a severe inflammation of the inside of the eye, usually due to infection, which can occur postoperatively or as a result of a systemic infection or trauma. Intravitreal antibiotics are administered directly into the vitreous cavity, allowing for higher concentrations of the medication to target the pathogens responsible for the infection. This method is crucial in effectively treating the condition due to the quick and potent action of the antibiotics in an area that may be difficult to reach otherwise. Oral antibiotics are not effective in managing this condition as they do not achieve the necessary concentrations within the eye to counteract the infection effectively. Topical steroid drops may help with inflammation but do not address the infectious component of endophthalmitis. Laser therapy is not a treatment for the infection itself; it may be used in some cases for different ocular conditions but is not relevant in the context of treating endophthalmitis. Therefore, the targeted and immediate efficacy of intravitreal antibiotics makes them the cornerstone of therapy for this potentially vision-threatening condition.