A U.S based study suggests a “high degree of suspicion” in patients with drug abuse leading to endogenous endophthalmitis as high as up to four folds, especially to recent trend of consuming intravenous opiates such as heroin. The morbidity and mortality rates from endogenous endophthalmitis worsens more with comorbidities like diabetes, malignancy, chronic kidney disease, Chronic obstructive pulmonary disease, immunodeficiency disease, liver cirrhosis, organ or tissue transplant and neutropenia. Early ocular diagnosis with timely physician consult remains key to preserving vision in such cases. Patients with substance abuse and its management present an altogether different level of approach in this COVID-19 era and thus requires a vigilant eye over the issue.

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