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Fungemia and Intraocular Involvement

Jonathan A. Barnett

The American Academy of Ophthalmology currently does NOT recommend routine Ophthalmology consults for visually asymptomatic patients with systemic candidemia. The incidence of candidemia-related endophthalmitis detected from routine screenings is <1%.

By contrast, if the patient has visual symptoms, an Ophthalmology consult is warranted.

  • Breazzano MP et al. American Academy of Ophthalmology Recommendations on Screening for Endogenous Candida Endophthalmitis. Ophthalmology. 2022 Jan;129(1):73-76.

Giant Cell Arteritis: Role of Ophthalmology

If a patient has systemic symptoms suspect of GCA (see “Rheumatology section”), when is it appropriate to consult Ophthalmology?

  • If patient HAS visual symptoms (acute vision loss, new onset diplopia), consult ophthalmology.

  • If patient DOES NOT have visual symptoms, DO NOT consult ophthalmology (e.g., to rule out “retinal vasculitis.”)

  • It is extremely unlikely that Ophthalmology will find a pertinent ocular finding in the absence of visual symptoms to support a diagnosis of GCA.

  • Bottom line: If you suspect GCA given the other systemic symptoms (regardless of visual status), treat promptly with high dose steroids!

  • Temporal Artery biopsies are typically performed by Vascular Surgery.