Phlegmon of the eye socket is an inflammatory disease that involves 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 departments - the eyelid, the lacrimal sac. That is why the concept of phlegmon is considered the collective name of several different vices. This disease is diagnosed quite rarely, but it poses a great danger to the state of he alth 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, the causative agents of such a 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 phlegmon of the orbit:
- all kinds of infectious or inflammatory skin diseases, for example, erysipelas, chronic furunculosis;
- penetrating organ injury;
- common blood poisoning;
- eye defects - conjunctivitis, damage to the lacrimal sac,barley;
- hit by a foreign object;
- inflammatory diseases of the sinuses;
- the presence of an infectious focus in the oral cavity - periodontal disease or caries.
Of course, it is not at all necessary that in the presence of these problems inflammation of the eye socket will occur. But weakened immunity, vitamin deficiency, poor nutrition become a 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 clearly. In the photo of the phlegmon of the eye socket, the symptoms characteristic of this rare defect are quite easily illustrated.
In general, all signs of this pathology can be divided into local and general. The first category includes:
- redness and slight bluing of the skin in the area of the damaged eye;
- big swelling in the area of inflammation;
- elevated temperature of the epithelium right in the focus of the disease;
- slight protrusion of the eye and difficulty moving it;
- the eyelids remain closed all the time, it is almost impossible to open the eye.
Other signs
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 eyelidsvision drops significantly.
Common signs of eye socket phlegmon include:
- increased 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 a childhood illness is characterized by general signs of the development of the pathological process.
Degrees of progression
Phlegmon of the cellular tissue of the orbit 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 area. Exophthalmos becomes more pronounced, the conjunctiva also swells, the eyeball gradually loses mobility, visual acuity drops significantly.
- The subperiosteal abscess stage begins when pus accumulates between the bone and periorbital wall. Signs of this stage: the eyes move slightly to the side opposite the abscess, redness and swelling appear on the eyelids, vision drops even more.
- Abscess of the orbit is considered the final stage in the development of pathology. At this stage, pus accumulates in the orbital tissues, a cavity is formed, which receives boundaries as a pyogenicshells. In addition, paralysis of the oculomotor muscles, compression of the optic nerve, and even complete loss of vision may occur.
It is worth saying that with timely diagnosis and treatment, it is possible to prevent the development of serious consequences and the transition of the disease to the next stages.
Clinical picture
Usually, with phlegmon of the orbit, purulent inflammation has a one-sided form and progresses quite quickly - from several hours to two days. If the pathological process covers the optic nerve, then this can provoke the occurrence of neuritis, thrombotic occlusion of vessels located on the injured tissue.
In the case of the transition of purulent phlegmon to the choroid of the organ, panophthalmitis is born, which often entails complete atrophy of the eyes. In advanced stages, brain abscess, meningitis, and sepsis may occur.
In some cases, the 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 eyelid to the outside.
Very often an abscess and phlegmon of the orbit 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 develops swelling of the eyelids, and the eye target is completely closed. The shade of the skin in the area of the eye becomes first red, and then cyanotic. The conjunctiva swells, acquires vitreous features. Probable exophthalmos. There is severe pain when pressing on the eye. At the same time, it is very possibledamage to the optic nerve and retina.
Diagnosis
To prevent deterioration of the general condition of the patient, you should contact a specialist when the first abnormal signs occur. It is very important to carry out the necessary diagnosis in time, confirm the alleged diagnosis and engage in appropriate treatment. To do this, you need to consult not only an ophthalmologist, but also an otolaryngologist, as well as a dentist.
To confirm the diagnosis of "phlegmon of the orbit", it is necessary to collect and analyze information from the anamnesis, learn about previous inflammations with purulent discharge, palpate and externally examine the damaged eye using an eyelid lifter.
To confirm the diagnosis, in addition to instrumental diagnostic methods, such as 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 the development of phlegmon is suspected, a general analysis and blood culture for sterility is carried out as laboratory diagnostic methods.
Treatment of phlegmon of the orbit
With this disease, the victim needs urgent hospitalization and prescription of drug therapy. Usually, loading doses of antibacterial agents with a wide spectrum of action, as well as symptomatic drugs for detoxification, are used to treat phlegmon. Tetracyclines, penicillins, sulfonamides are used in therapy.
If a patient hasa severe form of the disease is detected, accompanied by a pronounced clinical picture of intoxication, then symptomatic treatment with painkillers and antipyretics will be recommended.
In addition to parenteral administration of antibiotics, subconjunctival and retrobulbar injections are required. In parallel, it is recommended to perform maxillary sinusectomy with a change in the orbital wall, sinus puncture and ethmoidectomy, followed by the introduction of medications.
Need for surgery
Often, therapy is not complete without surgery - opening the phlegmon of the orbit. After cleansing the cavity from purulent fluid, the patient is placed inside the turunda - a special drainage soaked in antibiotics. The system is eliminated after only 2 days, and then an aseptic dressing is applied to the wound.
Often, ophthalmologists recommend UHF heating to patients, but this method of getting rid of orbital phlegmon can be effective only 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 tissue.
Consequences
In rare cases, phlegmon of the orbit can provoke the development of rather severe complications:
- abscess in brain tissue;
- sepsis;
- clot formation in sinus vessels;
- meningitis.
This disease is considered extremely rare, but extremely dangerous. In all cases, it progresses extremely rapidly, so when the first symptoms appear, you should immediately contact a qualified ophthalmologist.
