Ocular candidiasis — chorioretinitis or endophthalmitis — complicates a proportion of candidaemia and is often asymptomatic early, especially in sedated or ventilated patients. A dilated fundus examination by an ophthalmologist is widely recommended for patients with candidaemia, ideally within the first week of treatment, and in neutropenic patients after neutrophil recovery, when lesions become visible. Finding eye involvement changes management: it can alter the choice and duration of antifungal therapy and may need intravitreal treatment. A patient with candidaemia who later reports floaters or blurred vision needs urgent review.
- Arrange a dilated fundus examination for patients with candidaemia.
- Repeat the examination after neutrophil recovery in neutropenic patients.
- Report eye involvement to the treating team because it can change antifungal choice and duration.
- Review urgently any patient with candidaemia who develops floaters or blurred vision.
Why it matters
Ocular candidiasis is often silent until vision is threatened.
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