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Clinical outcomes of TASS are better with prompt diagnosis and treatment with topical corticosteroids and possibly cycloplegics. Typical presentations include blurred vision within 12–48 hours of surgery without salient complaints of pain; in general, TASS patients present sooner than do patients with endophthalmitis. “Limbus-to-limbus” corneal edema is characteristic of TASS and is uncommon for endophthalmitis. Other non-specific signs of anterior segment inflammation are common in both entities, such as anterior chamber cellular reaction, fibrin, and hypopyon (102).

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The posterior pole may be difficult to view if there is severe anterior chamber reaction. In these situations, the patient should have an ultrasound B-scan to rule out any posterior reaction. Both aqueous and vitreous taps are sent for culture to investigate for an infectious process. Although the pathophysiology remains elusive, TASS typically represents an inflammatory response to a noninfectious substance introduced into the eye during surgery.

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However, postoperative endophthalmitis and toxic anterior segment syndrome (TASS) remain important challenges. Both endophthalmitis and TASS can present as severe postoperative inflammation, and clinical characteristics may be used to differentiate between the two (Table 1). Without prompt treatment, both may lead to poor visual outcomes. Although these entities cannot be prevented completely, their rates may be decreased through risk reduction strategies supported by peer-reviewed evidence.

Toxic Anterior Segment Syndrome (TASS) is a rare and devastating complication of intraocular surgery. TASS is an acute sterile anterior chamber inflammatory reaction that usually develops hours after anterior segment surgery. Late-onset TASS has also been reported. The condition is responsive to topical steroids in most cases. Risk factors for endophthalmitis include preoperative, intraoperative, and postoperative factors. Preoperative factors include uncontrolled blepharitis or other ocular surface disease, diabetes mellitus, an immunocompromised state, infectious foci near the surgical site, and advanced age (5,10-12).

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