It is a possible complication of all intraocular surgeries, particularly cataract surgery, and can result in loss of vision or loss of the eye itself. The typical hallmark of TASS is an inflammatory process that starts within 24 hours of cataract surgery. Dr. Olsen has financial interests with iMacular Regeneration (Rochester, Minnesota). The infection is limited to the anterior segment of the eye, is always Gram stain and culture negative, and usually improves with steroid treatment. Endophthalmitis due to molds is rare in Western countries. If you sense that the patient's condition is worsening despite steroid treatment, then endophthalmitis is the likely diagnosis, and the patient should be treated promptly. Again, this is a differentiating point that is helpful but not definitive in regard to determining whether or not a patient has TASS. Endophthalmitis is a rare condition that affects your eyes. Residual OVD not flushed properly from the eye can be broken down into unfavorable components during sterilization or may retain detergents or enzymes from sterilization and be introduced into the anterior chamber, Dr. Adelman said. Unfortunately, there is no way to differentiate between TASS and endophthalmitis 100% of the time, Dr. Adelman said. Or post uveitis Endophthalmitis Panophthalmitis 3. If you have symptoms, see an ophthalmologist as soon as possible. Endophthalmitis is an infection of the tissues or fluids inside the eyeball. ... TASS vs Endophthalmitis Nawat Watanachai. He is a consultant to Allergan, Inc. Dr. Olson may be reached at (801) 585-6522; randall.olson@hsc.utah.edu. Even topical drops can be a culprit; preservatives or stabilizing agents that may be toxic to the endothelium can cause TASS if given access to the anterior chamber. Because TASS is a toxic insult, it virtually always shows up as an unusual inflammation on the day after surgery. Results of the Endophthalmitis Vitrectomy Study. A few signs and symptoms can help ophthalmologists decide the best course of treatment when examining the patient. One percent methylparaben-free lidocaine is now the most commonly used topical numbing agent and not associated with TASS, he added. Pupillary RISK FACTORS FOR POSTOPERATIVE ENDOPHTHALMITIS IDENTIFIED IN THE ESCRS STUDY 15 10. TASS cultures should always be negative and the vitreous should be clear, Dr. Adelman said. The trabecular meshwork is one of the less sensitive structures. Therefore, unusual changes on the day after surgery may indicate TASS, but alone this finding is not definitive. Regardless of how the patient responds to steroids during the day, he should be seen promptly the next day and monitored on a daily basis until a diagnosis is absolutely certain. Toxic Anterior Syndrome (TASS) is a rare sequela of uncomplicated anterior segment surgery. Endophthalmitis Vitrectomy Study Group. After phacoemulsification she developed a series of signs and symptoms on the anterior eye segment which plead for the diagnosis of endophthalmitis or toxic anterior segment syndrome (TASS). 58 In tropical countries, such as India, fungal endophthalmitis is a significant problem. That way at least we have covered the one that can cause significant damage to the retina and intraocular tissues.”. Reflecting the relative novelty of TASS, allegations in all but 3 of the 150 claims involve an infectious rather than an inflammatory process. If a patient’s symptoms resemble TASS or endophthalmitis, the most important thing to do is to first rule out infection, according to Dr. Adelman. The etiology of TASS is broad and includes any substance used during or immediately after anterior segment surgery that can be toxic to the eye, Dr. Adelman said. Toxic anterior segment syndrome (TASS) may be difficult to distinguish from infective endophthalmitis. 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