Purulent iridocyclitis

Description:

The purulent iridocyclitis is a noyny inflammation of an iris of the eye and a ciliary body of an eyeglobe.

Symptoms of the Purulent iridocyclitis:

Sharply expressed phenomena of irritation of an eyeglobe and severe pains in an eye are characteristic. There is an exudate in an anterior chamber which gains purulent character (hypopyon). An iris sharply of an infiltrirovan, greenish or rusty color, its vessels are expanded. Back synechias are quickly formed. The pupil badly gives in to action of mydriatic means. Opacifications in front department of a vitreous are noted. Purulent process can extend to all vascular highway of an eye, leading to an acute purulent uveitis and an entophthalmia.

Reasons of the Purulent iridocyclitis:

The iridocyclitis acute purulent arises by a hematogenous metastasis of microorganisms at sepsis, a septic endocarditis, cerebrospinal meningitis, acute quinsy, a disease of okolonosovy bosoms, an ugly face and other diseases, and also is exogenous — at the getting eye injury.

Treatment of the Purulent iridocyclitis:

Treatment is directed to the basic disease which caused an iridocyclitis stationary. Early use of antibiotics (the general and local) in a combination with sulfanamide drugs, co-administration of anti-inflammatory drugs and osmotherapy is shown. Locally — instillations of 1% of solution of Atropini sulfas of 5 — 6 times a day, 20% of solution Sulfapyridazinum sodium 4 times a day, solution of trypsin (1:5000) 4 of time a day, 1% of solution of Kanamycinum, 0,5% of solution of Monomycinum of 5 — 6 times a day. Subkonjyunktivalno — daily injections of benzylpenicillin of sodium salt on 300 000 PIECES and streptomycin - a calcium chloride complex on 50 000 PIECES, and also streptomycin - a calcium chloride complex on 50 000 PIECES with levomycetinum on 1 — 3 mg or gentamycin on 10 — 20 mg with levomycetinum on 1 — 3 mg; along with penicillin it is possible to apply Monomycinum on 50 000 PIECES, Kanamycinum on 20 mg or gentamycin on 20 mg. Retrobulbarno enter one of antibiotics: Monomycinum — 50 000 PIECES, Gentamycini sulfas — 20 mg, Kanamycinum — 50 mg, benzylpenicillin sodium salt — 300 000 PIECES, lincomycin a hydrochloride — 50 mg. They are dissolved in 0,5 — 1 ml 0,5% of sterile solution of novocaine. Antibiotics locally enter daily (to a hypopyon rassasyvaniye). If pus in an anterior chamber long does not resolve, carry out a cornea paracentesis with washing of an anterior chamber solution of 100 000 PIECES of benzylpenicillin of sodium salt and 100 000 PIECES streptomycin - a calcium chloride complex to 10 ml of isotonic solution of sodium of chloride. It is possible to apply to these purposes also 40 000 PIECES of lincomycin a hydrochloride in 10 ml of isotonic solution of sodium of chloride in combination with 20 mg of Neomycinum of sulfate. Appoint a penicillin electrophoresis (20 000 PIECES/ml) and streptomycin (20 000 PIECES/ml) 15 — 20 min. through a vannochkovy electrode. Both procedures are carried out daily at current 0,5 — 1,5 мА serially with an interval of 2 — 4 h.

The general treatment pursues introduction of high doses of antibiotics (intramusculary, intravenously) in combination with sulfanamide drugs. Along with massive doses of antibiotics and streptocides appoint vitamins C, V of B2, B6, PP. If it is necessary to suppress the suppurative focus in an organism giving a metastasis of microorganisms in eye tissue, antibiotics enter intravenously: benzylpenicillin sodium salt of 250 000 — 500 000 PIECES of 1 — 2 time a day. Ristomycinum sulfate is entered intravenously into 2 receptions in 12 h (a daily dose for adult 1 000 000 — 1 500 000 PIECES, a course — from 5 to 20 days). At the same time use a complex of the anti-inflammatory drugs applied to treatment of iridocyclites of various etiology.