Phlegmon of the eye socket is an inflammatory disease that encompasses fatty tissue and is characterized by the appearance of purulent discharge. In general, this pathology can occur not only in this area of the eye, but also in its other parts - the eyelid, the lacrimal sac. That is why the concept of phlegmon is considered the collective name of several different vices. This disease is rarely diagnosed, but it poses a great danger to the state of health and even human life.
Causes of occurrence
The main prerequisite for the development of purulent inflammation in any visual organ is the ingress of pathogenic microorganisms into it. Most often, pathogens of this pathology are streptococci, E. coli and staphylococci, which are able to penetrate into the fiber of the eye along with biological fluids or by contact. There are several specific reasons for the appearance of eye phlegmon:
- all sorts of infectious or inflammatory skin diseases, for example, erysipelas, chronic furunculosis;
- penetrating organ trauma;
- general blood poisoning;
- eye defects - conjunctivitis, damage to the lacrimal sac, barley;
- hit of a foreign object;
- inflammatory diseases of the nasal sinuses;
- the presence of an infectious focus in the oral cavity - periodontal disease or caries.
Of course, it is not necessary at all that in the presence of these problems, inflammation of the orbit will occur. But weakened immunity, vitamin deficiency, poor nutrition become the trigger for the emergence of such a dangerous disease.
Symptoms
In general, phlegmon of the orbit is considered the most common form of this pathology. This disease progresses rapidly in all cases and in just a day all its clinical signs appear, and quite brightly. In the photo, phlegmon of the orbit is quite accessible to illustrate the symptoms characteristic of this rare vice.
In general, all the signs of this pathology can be divided into local and general. The first category includes:
- redness and slight blueing of the skin in the area of the damaged eye;
- large edema in the zone of development of the inflammatory phenomenon;
- elevated temperature of the epithelium right in the focus of the disease;
- slight protrusion of the eye and difficulty in moving it;
- the eyelids remain closed all the time, open the eye is almost impossible.
Other symptoms
In addition, the victim feels severe pain, which increases with palpation and even a light touch on the organ. Even in case of slight swelling of the eyelids, vision decreases significantly.
Common signs of phlegmon of the eye socket include:
- increase in body temperature;
- fever and chills;
- severe weakness and decreased performance;
- headache.
It is noteworthy that in an adult patient, the disease is characterized by more pronounced local symptoms, but in childhood disease, common signs of the development of a pathological process are characteristic.
Degrees of progression
Phlegmon cellulose of the eye socket develops in stages, passing through various stages.
- The first stage is called preseptal cellulitis - there is swelling and inflammation of the tissues near the orbit. The eye bulges slightly, but its mobility remains, and vision problems are still completely absent.
- The second stage is orbital cellulitis, which is characterized by the appearance of edema in the eyelid zone. Exophthalmus takes on a more pronounced shape, the conjunctiva also swells, the eyeball gradually loses mobility, visual acuity decreases significantly.
- The stage of subperiosteal abscess begins when pus accumulates between the bone and periorbit wall. Signs of this stage: the eyes are slightly shifted to the side, opposite to the abscess, redness and swelling appear on the eyelids, vision drops even more.
- An orbital abscess is considered the final stage in the development of pathology. At this stage, pus accumulates in the orbital tissues, a cavity forms, which receives boundaries as a pyogenic membrane. In addition, paralysis of the oculomotor muscles, compression of the optic nerve, and even complete loss of vision may appear.
It is worth saying that with timely diagnosis and treatment, the development of serious consequences and the transition of the disease to the next stages can be prevented.
Clinical picture
Usually, with phlegmon of the eye socket, purulent inflammation has a one-sided form and progresses quite rapidly - from several hours to two days. If the pathological process covers the optic nerve, then this can trigger the occurrence of neuritis, thrombotic occlusion of blood vessels placed on injured fiber.
In the case of the passage of purulent phlegmon to the choroid of the organ, panophthalmitis arises, which often entails complete atrophy of the eyes. In advanced stages, a brain abscess, meningitis, and sepsis can occur.
In some cases, spontaneous removal of pus from the body is considered a favorable outcome of the disease. The substance breaks through the skin of the conjunctiva or eyelids to the outside.
Very often, an abscess and phlegmon of the eye socket go hand in hand. After all, the pathological process extends to nearby tissues and organs. An abscess, as already mentioned, is the last stage of the disease. In this case, the patient has swelling of the eyelids, and the ocular target is completely closed. The hue of the skin in the area of the eye becomes first red and then cyanotic. The conjunctiva swells, acquires vitreous features. Probably exophthalmos. There is severe pain with pressure on the eye. In this case, damage to the optic nerve and retina is very possible.
Diagnostics
To prevent a deterioration in the general condition of the patient, you should contact a specialist if the first abnormal signs occur. It is very important to carry out the necessary diagnostics in time, confirm the alleged diagnosis and take appropriate treatment. To do this, you need consultation not only with an oculist, but also with an otolaryngologist, as well as a dentist.
To confirm the diagnosis of “phlegmon of the eye socket”, it is necessary to collect and analyze anamnesis information, learn about previous inflammation with purulent discharge, palpate and examine the damaged eye with an eyelid.
To confirm the diagnosis, in addition to instrumental diagnostic methods, for example, radiography, ultrasound, orthopantomograms, diaphanoscopy and ophthalmoscopy can be performed - these procedures allow you to determine the condition of the optic nerve. First of all, if you suspect the development of phlegmon as a laboratory diagnostic method, a general analysis and blood culture for sterility are carried out.
Treatment eye phlegmon
With this disease, the victim needs urgent hospitalization and the appointment of drug therapy. Usually for the treatment of phlegmon, shock doses of antibacterial agents with a wide spectrum of action are used, as well as symptomatic detoxification drugs. In therapy, tetracyclines, penicillins, sulfonamides are used.
If a patient has a severe form of the disease, accompanied by a pronounced clinical picture of intoxication, then he will be recommended symptomatic treatment with painkillers and antipyretic drugs.
In addition to the parenteral administration of antibiotics, subconjunctival and retrobulbar injections are required. In parallel, it is recommended to perform a maxillary sinusotomy with a change in the orbital wall, sinus puncture and ethmoidotomy, followed by the introduction of medications.
The need for surgery
Often, therapy can not do without surgery - opening the phlegmon of the eye socket. After cleansing the cavity of purulent fluid, the patient is placed inside turunda - special drainage soaked in antibiotics. Eliminate the system in just 2 days, and then an aseptic dressing is applied to the wound.
Ophthalmologists often recommend that patients warm with the UHF method, but this method of getting rid of eye phlegmon can only be effective in the early stages of its development. Such a physiotherapeutic procedure makes it possible to localize the abnormal process and prevent the spread of purulent contents into the deep layers of damaged fiber.
Effects
In rare cases, phlegmon of the eye socket can provoke the development of quite serious complications:
- abscess in brain tissue;
- sepsis;
- blood clots in the sinus vessels;
- meningitis.
This disease is considered extremely rare, but extremely dangerous. In all cases, it progresses extremely rapidly, therefore, if the first symptoms occur, you should immediately contact a qualified ophthalmologist.