Endophthalmitis is an inflammation of the intraocular tissues of the aqueous and vitreous cavities. It is most commonly caused by microbial pathogens. However, sterile cases have been described in the literature Endogenous endophthalmitis is a rare but potentially blinding infection of the inner eye. It results from haematogenous spread of the microorganism from an infected site into the eye. Predisposing factors make this infection more likely.Fungal organisms are commonly responsible for endogenous endophthalmitis  and in the western world Candida albicans is the most common fungal pathogen . The majority of cases of endogenous fungal endophthalmitis (EFE) have been shown to occur in patients with debilitating disease, immunosuppression and recent hospitalisation .In order to disseminate the fungal pathogen it must reach the bloodstream. Yeasts can originate either from a primary fungal infection leading to a candidaemia or alternatively spread from an indwelling central venous catheter. Although rare, EFE has been reported in immunocompetent individuals ; in this group IV drug abuse is the most common inoculation risk factor  (Table. 1).
This was a serious case of bilateral endogenous fungal endophthalmitis; at presentation the infection in the right eye was advanced and did not respond to combined intravitreal and systemic antifungal therapy, this eye eventually required pars plana vitrectomy. The left eye infection was less advanced at presentation and responded fully to intravitreal and systemic antifungal therapy. The right vitrectomy sample was sent for pan-bacterial and pan-fungal polymerase chain reaction (PCR) analysis which confirmed the presence of C. albicans. All three vitreous aspirate samples showed no microbial growth.