Orbital phlegmon | MEDICH
Orbital phlegmon

Orbital phlegmon

Orbital phlegmon is diffuse purulent inflammation of the orbital tissue, followed by necrosis.

Etiology

The disease is usually caused by staphylococci and streptococci, the most common cause is inflammation in the paranasal sinuses, infection in injuries, operations in the oculo-orbital area, in diseases of the teeth, common infections, caused by squeezing on the face of boils, barley, as a complication of purulent dusryocystitis, as a one of purulent dystrophyticitis.

Orbital Phlegmon Clinic

The disease occurs, as a rule, acutely – a headache, chills, the body temperature rises. The doctor can watch the following: the eyelids sharply swollen, hyperemic, their expansion is difficult; severe conjunctival chemosis (pinching it in the palpebral fissure); exophthalmos, limited mobility of the eyeball or it is completely immobile. Vision is significantly reduced, up to light perception (as a result of the development of optic neuritis, thrombosis of the central retinal vein). After a few days, the eyelids become soft, fluctuation areas appear, and sometimes fistulas with the release of pus from them.

Orbital phlegmon treatment

Patients need emergency hospitalization. In the first stages of care, an opening of the orbit to a depth of 5 cm is shown not only in the fluctuation stage, but also in the inflammatory edema stage. The incision is made in the safest area – the outer part of the orbit. A turunda with a hypertonic solution or an antibiotic, which is changed daily, is introduced into it. Broad-spectrum antibiotics, detoxification drugs, sulfa and antihistamines, vitamins of group B, vitamin C are prescribed inside. In some cases osmotherapy is prescribed.

Progonosis with orbital phlegmon

The prognosis is serious both for the eye and for the life of the patient. The danger lies in intracranial complications: purulent meningitis, brain abscess, thrombosis of the cavernous sinus, sepsis; the proliferation of the inflammatory process contributes to the absence of valves in the veins of the orbit. Also, phlegmon may be complicated by a corneal ulcer, paralysis of the eye muscles, strabismus, ptosis, etc.

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