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careful! Severe infectious blinding eye disease - endophthalmitis

Posting time:2022-12-03 11:25:28

careful! Severe infectious blinding eye disease - endophthalmitis

Editor's note: Endophthalmitis is a serious ophthalmic emergency. The inflammatory reaction rapidly spreads to the tissues and fluids in the eye, including the aqueous humor, vitreous, retina, uvea and even sclera, and even the cornea and orbital tissue, and develops into periocular inflammation. Even with massive antibiotics and surgery, vision loss cannot be avoided. Therefore, timely detection of endophthalmitis, identification of pathogens, and proper treatment are very important for saving patients' vision or reducing visual impairment. What is endophthalmitis? Endophthalmitis, also known as vitreous inflammation, broadly refers to various severe intraocular inflammations, such as intraocular infection, intraocular foreign body, tumor necrosis, severe non-infectious uveitis, lens cortex allergy, etc. Empyema and eye pain. Clinically, it generally refers to infectious endophthalmitis caused by bacteria, fungi or parasites. According to different infection routes, it is divided into extrinsic endophthalmitis and endogenous endophthalmitis, among which exogenous endophthalmitis is more common. Extrinsic endophthalmitis: The source of infection comes from outside the body, and bacteria or fungi enter the eye through surgery, injection into the eye, or eye injury. Puncture wounds to the eye are the most common cause of endophthalmitis, and symptoms usually follow eye surgery or injury start within a few days. Endogenous endophthalmitis: This is the second major type of endophthalmitis, in which pathogenic bacteria enter the eye through blood from purulent lesions in other parts of the body, such as bacterial endocarditis, purulent meningitis, and sepsis. . According to the speed of onset, it can be divided into acute and chronic endophthalmitis: Acute endophthalmitis: most of the onset occurs within 24 to 48 hours after surgery or trauma, and the pathogens are highly virulent, such as Staphylococcus aureus, Streptococcus, etc. Rapid onset, rapid development, if not treated in time can lead to panophthalmitis and even eyeball atrophy. Chronic endophthalmitis: Most of them occur within 2 weeks to 2 years after surgery, with a high incidence period from 2 weeks to 2 months. The virulence of pathogens is weak, such as Staphylococcus epidermidis, Candida albicans and so on. The symptoms are atypical, mainly manifested as recurrent uveitis, which can be improved but not cured by glucocorticoid treatment. What are the symptoms of endophthalmitis? The most common symptoms of endophthalmitis are: Eye pain that worsens after surgery, injection, or eye injury Redness and swelling of the eye White or yellow pus or discharge The most common type of eye surgery, both can cause endophthalmitis, but are less common. If you experience any of the above-related symptoms, see your ophthalmologist immediately to prevent the infection from getting worse quickly. How is endophthalmitis diagnosed and treated? An ophthalmologist will perform several tests to diagnose endophthalmitis: examine the eye and test vision. Ask about recent surgery, eye surgery, or eye injury. If the eye is injured, the doctor may do an ultrasound to look for a foreign object in the eye. If an eye infection is suspected, the doctor will perform a bacterial culture on an etiological smear to test for infection. Through anterior chamber puncture, wound secretions or excised intraocular tissue, etc., the extraction of vitreous humor for bacterial culture has the most diagnostic value. The positive rate of bacterial culture for endophthalmitis is about 56%. Those with positive bacterial culture should do bacterial species identification and drug sensitivity test. For endophthalmitis, the usual treatment is to inject antibiotics or antifungals into the eye. In addition, glucocorticoids can be taken to reduce swelling and inflammation caused by the infection. For more serious infections, vitrectomy surgery may be performed. What measures can help prevent endophthalmitis? The following measures can help prevent endophthalmitis and reduce the risk of vision damage: Wear protective eyewear when doing things that may damage your eyes, including work such as sawing wood. Wear appropriate glasses and safety gear during contact sports. After eye surgery or eye injections, follow your doctor's care instructions. For example, wash your hands before applying eye drops; do not let the mouth of the eye drop bottle touch your eyes to prevent contamination of the dropper. Reference:

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