Objective:

To investigate injection drug use–associated endogenous endophthalmitis (IDU-EE) and identify critical opportunities for early intervention in patients with substance use disorders (SUD) to improve health outcomes.

Key Findings:

• Fentanyl use was associated with worse visual outcomes compared to other drugs.
• Patients presenting with acute vision loss, floaters, eye pain, or photophobia should be evaluated for IDU-EE.
• No opioid use disorder medication was administered without addiction consult services involvement, highlighting a critical gap in care.

Interpretation:

The study highlights the critical role of ophthalmologists in identifying and treating IDU-EE while also addressing underlying substance use disorders through coordinated care, which is essential for improving public health outcomes.

Limitations:

• Limited access to ophthalmic equipment in some emergency departments may hinder diagnosis.
• The study's findings may not be generalizable beyond the specific healthcare system analyzed, and potential biases in data collection should be considered.

Conclusion:

Ophthalmologists have a unique opportunity to connect patients with substance use disorders to addiction treatment during hospitalization for IDU-EE, potentially improving both vision and overall health outcomes through interdisciplinary collaboration.