The United States experienced a tripling in the number of opioid overdose deaths from 2000 to 2014. In particular, the Northeast region has the highest age-adjusted rate of deaths associated with drug use, at 16.1 per 100 000 persons.1 In New Hampshire, the rate is even higher, at 26.2 per 100 000 persons.1
A devastating sequela of injection drug use (IDU) is endogenous endophthalmitis (EE).2 Injection drug use can lead to transient microbial bloodstream infection from use of a nonsterile injection apparatus, which can seed ocular infection.3 The prognosis of EE is poor, with nearly 50% of affected eyes having no light perception despite treatment.2 We investigated clinical characteristics of IDU vs non-IDU EE at Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, during the opioid epidemic.