Endophthalmitis

Purulent inflammation of the inner membranes of the eye.
It is a consequence of eye disease, trauma, accompanies other purulent processes in neighboring or remote organs, the infection of which spreads through the blood.
Characteristic pain in the eye. Vision is sharply reduced, up to light sensation. Eyelids are edematous. Conjunctiva red, like eyelids, edematous. There is a corneal edema. In the anterior chamber there is a level of pus (hypopion). Iris is dirty, its dilated vessels are visible. The eye pressure is reduced, the eye is soft to the touch. The process develops sharply, acquires a sometimes protracted, chronic course, possibly the development of panophthalmitis (see).
Mandatory in the hospital. Intensive local and general antibiotic and anti-inflammatory therapy. Under the conjunctiva introduce: monomycin 50,000 units, 20-40 mg gentamycin sulfate, 50-100 mg ampicillin, 5 g polymyxin sulfate B, 50 mg kanamycin. These drugs are injected under the eye (parabulbarpo) or behind the eye (retrobulbarno). The anterior chamber is washed with trypsin solution, with a weak antibiotic solution. In the vitreous are injected 0.1 ml (2000 ED) of benzylpenicillin sodium salt, 1 mg streptomycin. General treatment: Benzylpenicillin sodium salt to 250,000 units every 4 hours intramuscularly, 4% gentamicin solution at 40 mg. Intravenous - benzylpenicillin sodium salt, ristomycin sulfate. Inside are recommended: erythromycin according to 0.25 g, metacycline hydrochloride by 0.3 g, levomycetin by 0.5 g; Sulfonamides: sulfadimezin 1 g 4 times a day, sulfapiridazine sodium 2 g in the 1 st day and 0.5-1 g for the next 5-7 days. Corticosteroid, detoxifying, desensitizing and resorptive therapy is used. In severe cases, a surgical removal of a part of the vitreous body (vitreoectomy) is performed. As a result of endophthalmitis, the eyeball may diminish in size (subatrophy or atrophy of the eye). The prognosis with endophthalmitis is always serious. Even if you manage to cope with inflammation - the visual functions suffer significantly.