Entophthalmia

Description:

The entophthalmia - a purulent inflammation of internal covers of an eyeglobe at which pus impregnates a vitreous or forms abscess in a vitreous. There can be a full fusion of internal covers of an eyeglobe.

Entophthalmia symptoms:

Eye pains, moderate hypostasis a century and conjunctivas, the sharp mixed injection of an eyeglobe and sharp decrease in visual acuity, sometimes before photoperception are characteristic. The endothelium of a cornea is edematous, in an anterior chamber quite often there is a hypopyon or fibrinous exudate. The iris is hyperemic, an infiltrirovana. In the presence of a transparent crystalline lens in an initial stage of development of an entophthalmia at a research in the passing light floating opacities in a vitreous are visible, then the yellow-gray or yellow-greenish reflex from an eyeground appears. At a research in the passing light sharp weakening of a reflex from an eyeground or its absence is noted. A characteristic sign of an entophthalmia is formation of abscess in a vitreous which causes a yellowish luminescence of a pupil. Intraocular pressure usually decreases, the purulent septic entophthalmia quickly passes into a panophthalmia. In the regressive period of development of an entophthalmia the reflex behind a crystalline lens gets a whitish shade owing to formation on site of abscess of connecting fabric. Surface of exudate of a vitreous smooth. There are rough connective tissue shvarta. It quite often conducts to traction amotio of a retina, an eyeglobe subatrophy.

Entophthalmia reasons:

The entophthalmia develops as a result of infection of internal covers of an eye and a vitreous, mainly after the getting wound of an eye, band operations on an eyeglobe, at perforated helcomas or, much more rare, owing to innidiation of the activator from any center of an inflammation at purulent septic processes in eye tissues.

Treatment of the Entophthalmia:

At a septic entophthalmia - massive general and local antiinflammatory therapy by antibiotics in a combination with streptocides and osmotherapy. Locally under a conjunctiva enter benzylpenicillin sodium salt daily on 200 000 PIECES, streptomycin a calcium chloride complex on 100000 PIECES or Monomycinum on 50000 PIECES, 20 - 40 mg of Gentamycini sulfas, 50-100 mg of ampicillin, 10 mg of a karbenitsillin of disodium salt, 50 mg of Cefaloridinum, 5 mg of polymyxin of sulfate B, 50 mg of Kanamycinum, 40 mg of Tobramycinum. These antibiotics apply as well retrobulbarno (parabulbarno).

The anterior chamber of an eye is washed out solution of trypsin (1:5000) and enter into it 0,1-0,25 ml of solutions of antibiotics: 2 mg of levomycetinum, 2 mg of erythromycin, 2,5 mg of Neomycinum of sulfate, 0,1 mg of polymyxin of sulfate B, 5 mg of streptomycin, 10 000 PIECES of benzylpenicillin of sodium salt. Enter into a vitreous 0,1 ml (2000 PIECES) of benzylpenicillin of sodium salt, 1 mg of streptomycin, 8 mkg/ml of gentamycin.

The general treatment consists in purpose of high doses of antibiotics. Intramusculary enter benzylpenicillin sodium salt on 250 000 PIECES in each 4 h into combinations from 500 000 PIECES of streptomycin of sulfate 2 times a day (on a course - to 10000000-15000000 PIECES of benzylpenicillin of sodium salt and 5000000-8000000 PIECES of streptomycin of sulfate), 4% gentamycin solution on 40 mg daily; intravenously - benzylpenicillin sodium salt, Ristomycinum sulfate.

Are inside recommended erythromycin on 0,25 g, metacycline a hydrochloride on 0,3 g, levomycetinum on 0,5 g, ampicillin on 0,25 g, Oxacillinum sodium salt on 0,25 g; streptocides: Sulfadimezinum on 1 g 4 times a day, Sulfapyridazinum-sodium-2 of in the 1st day and on 0,5 - 1 g in the next 5-7 days; intravenously - 40% hexamethylenetetramine solution on 5-10 ml daily (12-15 injections). At the initial phenomena of a traumatic entophthalmia the paracentesis with washing of an anterior chamber of an eye solution of benzylpenicillin of sodium salt (100000 PIECES) and streptomycin of a calcium chloride complex (100000 PIECES), divorced in 10 ml of isotonic solution of sodium of chloride is recommended. Also corticosteroid, disintoxication, desensibilizing and resorptional therapy is applied. Carry out surgical removal it is purulent-infiltrirovannogo a vitreous with simultaneous washing of a cavity of an eye solutions of antibiotics.