Cellulite of the eye. Inflammation of the fatty tissue of the orbit - cellulitis of the orbit. In the long term, there may be

Cellulitis (phlegmon) eye sockets is a diffuse purulent inflammatory disease her fat body. Appears acutely and progresses very quickly with processes general intoxication- chills heat body, occasionally brain disorders. The causes of the disease are considered to be purulent phenomena in the face (furuncles, erysipelas, barley, eyelid abscess, purulent dacryocystitis, purulent sinusitis). Phlegmon of the orbit can be provoked by trauma to the orbit with infection of tissues with pyogenic microbes, ingress of infected foreign bodies into the orbit. Quite rarely, this pathology is observed in infectious diseases (flu, scarlet fever, typhoid). Orbital phlegmon also develops as a result of the spread of a purulent phenomenon from a neighboring focus of infection to retrobulbar tissue (opened subperiosteal abscesses).

treatment

The use of antibiotics intramuscularly, orally, in difficult cases intravenously is shown. If there are areas of fluctuation, wide tissue incisions are recommended with introduction into the cavity of the orbit, the use of turundas for drainage of the wound cavity, the use of a bandage with hypertonic saline sodium chloride. If the cause of the phlegmon of the orbit is found, the underlying disease is treated. Urgent use of antibiotics in therapeutic doses significantly improves the prognosis of the disease.

symptoms

The process is often unilateral, progresses unexpectedly and quickly (over several hours or 1-2 days), characterized by symptoms:

• headache
• pain in the eyelids and eye sockets
• pain increases with palpation and eye movements
• eyelids swollen, hyperemic and tense, almost impossible to open
• general state the patient is severe (weakness, high body temperature)

Traffic restrictions set very quickly eyeball and exophthalmos. If the formation of phlegmon was preceded by osteitis of the walls of the orbit or periostitis, the displacement of the eyeball is likely. With the progression of inflammation, chemosis of the conjunctiva of the eyeball occurs, the swollen mucous membrane does not fit into the conjunctival sac and is clamped by edematous eyelids, exophthalmos intensifies, the eyeball becomes almost motionless, vision drops sharply. Between the protruding eye and the edge of the orbit, the swollen contents of the orbit are palpated. When involved in inflammation optic nerve neuritis is manifested with the dominance of retinal vein thrombosis and congestion. Due to trophic disorders provoked by compression of the nerves, keratitis and festering ulcer cornea. The inflammatory process often switches to the retina, choroid eyes and excites purulent choroiditis and panophthalmitis with possible atrophy of the eye. When the process is separated, an abscess is formed in the orbit, which can spontaneously open through the skin or conjunctiva.

prevention

Timely and correct treatment various inflammatory processes on the face, chronic inflammatory phenomena in the eye socket, when it is infected - emergency treatment antibiotics and sulfonamides.

What is cellulite (phlegmon) eye sockets

What provokes Cellulite (phlegmon) of the eye sockets

The causes of the disease are purulent processes in the face (erysipelas, boils, barley, purulent dacryocystitis, eyelid abscess, purulent sinusitis). Orbital phlegmon can be caused by injuries of the orbit with tissue infection with pyogenic microbes, as well as the introduction of infected foreign bodies into the orbit. Rarely, this pathology occurs in infectious diseases (scarlet fever, influenza, typhoid). Phlegmon of the orbit also occurs as a result of the spread of a purulent process from a neighboring focus to retrobulbar tissue (erupted subperiosteal abscesses).

Symptoms Cellulitis (phlegmon) eye sockets

The process is usually unilateral, develops suddenly and quickly (within a few hours or 1-2 days).

There are pain in the eyelids and eye sockets, headache. The pain is aggravated by palpation and eye movements. The eyelids are hyperemic, edematous and tense, it is almost impossible to open them. The general condition of the patient is severe (high body temperature, weakness).

Restriction of the mobility of the eyeball and exophthalmos quickly set in. In cases where the development of phlegmon was preceded by periostitis or osteitis of the walls of the orbit, a displacement of the eyeball is possible. As inflammation develops, chemosis of the conjunctiva of the eyeball appears, the edematous mucous membrane does not fit into the conjunctival sac and is infringed by edematous eyelids, exophthalmos increases, the eyeball becomes almost motionless, vision is sharply reduced. Between the protruding eye and the edge of the orbit, the swollen contents of the orbit are palpated.

When involved in inflammatory process optic nerve develops neuritis with a predominance of congestion and retinal vein thrombosis. As a result of trophic disorders caused by compression of the nerves, keratitis and a purulent corneal ulcer are sometimes observed. Inflammation often passes to the choroid, retina and causes purulent choroiditis and panophthalmitis, followed by atrophy of the eye. When the process is delimited, an abscess forms in the orbit, which sometimes spontaneously opens through the skin or conjunctiva.

The inflammatory process can go to meninges and venous sinuses (cavernous sinus). Sepsis may develop. A stormy onset, a rapid progressive and severe course distinguish the phlegmon of the orbit from tenonitis.

Diagnosis Cellulitis (phlegmon) of the orbit

An x-ray of the paranasal sinuses and orbit is necessary, which is important for the differential diagnosis of phlegmon of the orbit from periostitis of the orbital wall, as well as to exclude the ingress of a foreign body into the orbit in case of injury.

Treatment Cellulite (phlegmon) eye sockets

The use of antibiotics inside, intramuscularly and in severe cases intravenously. Intramuscularly - benzylpenicillin sodium salt 500,000 IU 4 times a day, methicillin sodium salt 1-2 g every 6 hours (before administration, the drug is dissolved in bidistilled water or 0.5% novocaine solution), oxacillin sodium salt 0.25 -0.5 g every 4-6 hours (then after a few days they switch to oral administration of 1 g every 4-6 hours); 4% solution of gentamicin 40 mg, kanamycin sulfate 0.5 g every 8-12 hours. Gentamicin and kanamycin, despite high efficiency in the treatment of staphylococcal purulent infection, due to nephrotoxic and ototoxic effects, it is used to a limited extent and only in cases where other drugs do not give an effect.

For intravenous administration of benzylpenicillin, the sodium salt is dissolved in 10 ml of water for injection or sterile isotonic solution sodium chloride, administered 1-2 times a day in combination with intramuscular injections. Daily dose benzylpenicillin sodium salt for intravenous administration 2,000,000-3,000,000 units. Ristomycin sulfate is administered intravenously by drip, dissolving in a sterile isotonic sodium chloride solution. Pour in 500,000 IU of ristomycin sulfate (250 ml of solution) for 30-60 minutes 1-2 times a day. At the end of the infusion, without removing the needle, it is recommended to inject 10-20 ml of isotonic sodium chloride solution (to prevent phlebitis). If there are contraindications to the abundant administration of fluid required amount the drug is dissolved in 20-40 ml of 5% glucose solution or isotonic sodium chloride solution and injected (very slowly!) intravenously. The dose at the first administration of ristomycin sulfate should not exceed 250,000 IU. The daily dose of ristomycin sulfate for adults is 1,000,000-1,500,000 IU: this dose is administered in 2 divided doses (with an interval of 12 hours). The duration of the course of treatment depends on the course of the disease. Inside give erythromycin, oleandomycin phosphate, lincomycin hydrochloride, ampioks, ampicillin. Intravenously administered 40% solution of hexamethylenetetramine 10 ml (5-10 infusions), 40% glucose solution 20 ml with ascorbic acid(10-15 infusions). If there are areas of fluctuation, wide tissue incisions are shown with penetration into the orbital cavity, insertion of turundas for drainage of the wound cavity, dressings with hypertonic (10%) sodium chloride solution.

When the cause of the phlegmon of the orbit is identified, the underlying disease is treated (inflammatory processes of the paranasal sinuses, etc.). The urgent use of antibiotics in the required doses significantly improves the prognosis of the disease.

Which doctors should be consulted if you have cellulitis (phlegmon) of the eye sockets

Ophthalmologist

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(orbital cellulitis) - diffuse purulent inflammation of the orbital tissue. Phlegmon of the orbit is characterized by a severe general condition (headache, nausea, febrile temperature), throbbing pain in the orbit, exophthalmos, diplopia, edema and hyperemia of the eyelids, conjunctival chemosis, decreased visual acuity, limited mobility of the eyeball. Diagnosis of phlegmon of the orbit involves establishing a relationship between the disease and purulent infections(sinusitis, facial furuncles, dacryocystitis, complicated orbital injuries, etc.), radiography, ultrasound, CT of the orbit and paranasal sinuses nose, orthopantomograms. Treatment requires systemic and local application antibiotics, opening and drainage of the phlegmon of the orbit.

General information

Phlegmon of the orbit (orbital cellulitis) is a serious problem in surgical ophthalmology. Despite its relatively low occurrence (about 1% of cases in the population), orbital phlegmon can be dangerous not only for visual function but also for the life of the patient. With the spread of a purulent process along the venous bed from the orbit into the cranial cavity, dangerous complications- thrombosis cerebral vessels and meningitis, which in 20% of cases lead to the death of patients. Phlegmon of the orbit can occur at any age, but is more common in children under 5 years of age.

Causes of phlegmon of the orbit

The development of phlegmon of the orbit is etiopathogenetically closely related to purulent diseases eyes, paranasal sinuses, dentoalveolar system, skin, injuries of the facial skeleton, general infections.

About 70% of cases of orbital phlegmon is an orbital complication of sinusitis, especially ethmoiditis. Purulent fusion of orbital tissue can also be caused by the penetration of infection from nearby foci of inflammation: teeth and jaws (with osteomyelitis upper jaw, periodontal abscess), facial skin (with furunculosis, erysipelas), eyes (with barley, dacryocystitis, phlegmon of the eyelid, infected orbital injuries, complicated foreign bodies of the eye), etc. Less commonly, the cause of phlegmon of the orbit is purulent metastasis during sepsis, complicated course common infections(flu, scarlet fever, typhus).

Phlegmon of the orbit, as well as phlegmon of other localization, in most cases is caused by Staphylococcus aureus and white, hemolytic and greenish streptococcus, less often by pneumobacillus, diplococcus, Escherichia coli. Pathogens penetrate into the periorbital tissue through the facial veins and veins of the orbit, which do not have valves. In this case, small pustules are first formed, then merging into large abscesses.

Classification of the stages of the phlegmon of the orbit

The purulent process in the orbital tissue develops in stages, passing through the stages of preseptal cellulitis, orbital cellulitis, subperiosteal abscess, and the actual abscess and phlegmon of the orbit. In this case, timely therapy can interrupt further development inflammation at any stage.

Preseptal cellulitis is characterized inflammatory edema tissues of the orbit and eyelids, slight exophthalmos, however, the mobility of the eye at this stage is preserved, and vision is not impaired. Further progression infectious process and its distribution in back departments orbit causes the development of orbital cellulitis. This form is clinically manifested by edema of the eyelids, exophthalmos, chemosis, limited mobility of the eyeball and decreased visual acuity. If pus accumulates between the periorbital and bone wall orbit, leading to the destruction of the latter, a subperiosteal abscess of the orbit is formed. At this stage, edema and hyperemia are noted. upper eyelid, impaired mobility and displacement of the eyeball in the direction opposite to the location of the abscess, exophthalmos, impaired visual acuity.

Orbital abscess is characterized by the accumulation of pus in the orbital tissues with the formation of a cavity, limited by the pyogenic membrane. In addition to the above signs of purulent orbital inflammation, an abscess of the orbit can develop ophthalmoplegia, compression of the optic nerve and blindness. With diffuse inflammation of the orbital tissue, they speak of phlegmon of the orbit.

Symptoms of phlegmon of the orbit

Purulent inflammation with phlegmon of the orbit is usually unilateral and rapidly develops (from several hours to 1-2 days). In this case, there is a sharp throbbing pain in the eyelids and the orbit, which increases with the movements of the eyeball and palpation. The eyelids are sharply swollen, have a red-violet tint, are tense, they cannot be opened. As inflammation increases, conjunctival infringement develops in palpebral fissure(chemosis), diplopia, exophthalmos, displacement and immobility of the eyeball, a sharp decline vision. With phlegmon of the orbit, the general condition of the patient is rapidly deteriorating: malaise, headache, nausea, and fever are increasing.

With the transition of the inflammatory process to the optic nerve, neuritis develops, thrombotic occlusion of the retinal veins, neuroparalytic keratitis with the formation of a purulent corneal ulcer. When the vascular and other membranes of the eye are involved in purulent inflammation, choroiditis and panophthalmitis occur, followed by atrophy of the eye.

Critical complications of phlegmon of the orbit can be brain abscess, meningitis, thrombosis of the venous sinuses, sepsis. A relatively favorable outcome of the phlegmon of the orbit can be considered a spontaneous breakthrough of pus through the conjunctiva or the skin of the eyelid to the outside.

Diagnosis of phlegmon of the orbit

A patient with phlegmon of the orbit should be immediately consulted by an ophthalmologist, otolaryngologist and dentist. The diagnosis of phlegmon of the orbit is facilitated by the analysis of anamnestic data: the presence of previous purulent processes maxillofacial region characteristic clinical picture, external examination eyes using an eyelid lifter, palpation.

Required instrumental diagnostics includes ultrasound and radiography of the orbit, ultrasound and x-ray examination of the paranasal sinuses, orthopantomogram. For clarifying purposes, diaphanoscopy, ophthalmoscopy to assess the condition of the optic nerve, exophthalmometry, biomicroscopy, orbital CT, etc. can be used. laboratory tests with phlegmon of the orbit, priority diagnostic value have a general clinical blood test and blood culture for sterility.

Phlegmon of the orbit should be differentiated from phlegmon of the eyelid, acute dacryocystitis, tenonitis, periostitis of the orbital wall, foreign body of the orbit, retrobulbar hemorrhage, glioma, sarcoma,

Orbital cellulitis (cellulitis of the eye socket), this is rare, but enough dangerous disease. If help is not provided to the patient in a timely manner, then this is a direct threat to his life. A purulent process can spread along the venous bed of the orbit, which causes complications such as meningitis or thrombosis of the cerebral vessels. In 20% of cases, they lead to the death of the patient. Most often, the disease affects children under 5 years of age.

What it is

Orbital cellulitis is an inflammatory process that occurs as a result of infection in the orbit and affects the tissue behind the orbital septum.

The disease develops very quickly and is accompanied by symptoms of general intoxication. You won't be able to get rid of it on your own. You must immediately seek medical help.

The reasons

The causes of orbital cellulitis are bacterial infection. Most often, the disease is caused by bacteria such as:

• golden staphylococcus aureus;
• Pneumococcus;
• streptococcus;
• diplococcus;
• coli.

The following pathologies can provoke orbital cellulitis:

In 70% of cases, the cause of the development of orbital cellulitis is a complication of sinusitis (in particular, ethmoiditis).

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Symptoms of orbital cellulitis

The disease can develop in a few hours, a maximum of 2 days. In most cases, it affects one eye and manifests itself in the form of the following symptoms:

• my head starts to hurt a lot. Unpleasant sensations aggravated by eye movement;
• there is pain in the region of the eyelid and orbit. On palpation, it becomes stronger;
• the eyelids turn red, become swollen and tense, it is difficult to open them;
• icteric coloration of the sclera occurs;
• symptoms of general intoxication increase, the patient has a fever, chills, lethargy;
• as the disease progresses, the eye protrudes and is infringed by swollen eyelids. This occurs because the mucous membrane increases in size as a result of edema; and does not fit in the conjunctival sac;
• as a result of this, the eye is fixed without movement, vision deteriorates sharply;
• swollen contents are felt between the protrusion of the eye and the edge of the orbit;
• damage to the optic nerve may occur in the process. This can provoke the development of neuritis and retinal vein thrombosis;
• trophic disorders such as keratitis or a purulent ulcer can appear when a nerve is pinched;
• if the disease gives a complication to the retina, purulent panophthalmitis or choroiditis occurs, which subsequently leads to eye atrophy;
• if the process is limited, an abscess may form in the orbit, which in some cases opens spontaneously. Content flows out through the conjunctiva or skin. In this case, the formation of a poorly healing fistula is possible.

Complications

With timely treatment, the prognosis is favorable.

The disease can cause the following complications:

• meningitis;
• blood poisoning;
• thrombosis of the cavernous sinus;
• hearing loss;
• visual impairment.

In the long term, there may be:

1. thorn,
2. strabismus,
3. amblyopia,
4. optic atrophy.

Diagnostics

An ophthalmologist can diagnose the disease after visual inspection and history taking. Also, the patient should be consulted by a dentist, an otolaryngologist and an infectious disease specialist.

A blood test is not always informative, since the number of leukocytes may be normal.

If there is confidence that this is orbital cellulitis, it is possible to conduct a magnetic resonance or computed tomography. If cavernous sinus thrombosis is suspected, MRI is preferred.

In differential diagnosis, the disease must be distinguished from the following pathologies:

• pseudotumor of the orbit;
• preseptal cellulitis;
• phycomycosis;
• orbital abscess;
• metastatic lesion.

It is also necessary to perform fluoroscopy of the sinuses and orbit. The picture will help differential diagnosis and exclude the presence of a foreign body in the eye.

If meningitis is suspected, a lumbar puncture is performed. And in the event that there is a suspicion of sinusitis, a sowing of the discharge from the nasal sinuses is done.

The direction of ptosis may indicate the location of the infection. If the source of infection is located on the side lattice labyrinth, then the protrusion of the eyeball occurs laterally and outward. And if he is on the side frontal sinus, then the eye protrudes downward and outward.

Treatment

Treatment of orbital cellulitis is carried out in ophthalmological departments under the supervision of medical personnel.

For treatment severe forms diseases use antibiotics

• if the cause of the disease is an eye injury or a foreign body is prescribed combination therapy antibiotics. It is aimed at combating gram-positive and gram-negative microorganisms: Vancomycin 1 g intravenously twice a day, Ertapanem 100 mg intravenously once a day. The duration of treatment is seven to ten days;
• in the presence of sinusitis, the disease is treated with antibiotics from the group of cephalosporins of the 2nd or 3rd generation. Drugs (Ceftriaxone, Cefotaxime) are administered intravenously every 6 or 12 hours.

The choice of drug for the treatment of the disease and the dosage is determined by the doctor, depending on the age of the patient and the severity of the disease. In most cases, assigned maximum doses medicines.

Also, for the treatment of orbital cellulite, the following drugs can be prescribed.

• Streptomycin 500,000 IU twice a day;
• Tetracycline tablets 250 mg in combination with Nystatin 100 mg twice a day;
• Sulfapyridazine 500 mg. During the first day, up to four tablets are prescribed, then the dose is reduced;
• Gentamicin twice a day;
• Benzylpenicillin 500,000 IU four times a day.

In order to reduce intoxication, 40% glucose and ascorbic acid are administered intravenously.

Treatment is continued for 2 weeks. Hexamethylenetetramine 40%, 10 ml is also used intravenously.

Additionally, they can be assigned eye drops with an antibiotic (Normax, Tobrex, Tsipromed) and fortified conjunctival solutions.

Surgical intervention

If the cause of the disease is an abscess of the paranasal sinuses and an abscess of the jaw, it is immediately opened and drained. If there is no effect, the same procedure is carried out to eliminate orbital abscesses.

Indications for drainage of an abscess, opening of infected sinuses, or surgical decompensation of the orbit are:

• loss of visual acuity;
• suspicion of the presence of an abscess;
• suspicion of the presence of a foreign body;
• instrumentally identified orbital process;
• ineffectiveness of antibiotics.

The operation is carried out under a general or local anesthesia in the following way:

• if a superficial abscess is opened in the region of the upper eyelid, the tissues are cut through the center of the infiltrate accumulation. The dissection is carried out in the region of the upper inner or upper outer edge of the orbit. If the infiltrate is localized in the region of the lower eyelid, incisions are used along the lower inner or lower outer edge of the orbit, retreating from it half a centimeter up or down;
• if a deep process is opened, the lower edge of the wound is exfoliated from the periosteum;
• For opening and draining deep process incise the orbital septum in the place where it is attached to top edge orbits. By breaking down the fiber upper section eye sockets open abscess. In the future, using a hemostatic clamp, they pass behind the eyeball.

After opening, antiseptic treatment is prescribed:

• Sulfacyl sodium;
• Rivanol, Hydrogen peroxide 3%;
• Ichthyol, Camphor ointment;
• Physiotherapy procedures (Sollux lamp).

In the first days, dressing is done 2-3 times a day, and then once.

Phlegmon of the orbit of the eye (the second name is orbital cellulitis) is an inflammation purulent nature, which covers the orbital tissue. This disease is recognized as a serious problem in the field of ophthalmology. surgical direction. Characterized severe course and a host of symptoms. In addition to violations visual apparatus the patient feels general malaise which is expressed by nausea, subfebrile temperature and severe headache.

Phlegmon of the orbit refers to diseases with a low frequency of diagnosis. But its consequences can be dangerous not only for the organs of vision, but also for the life of the patient as a whole. Progression and distribution purulent inflammation can cause complications such as meningitis or cerebral thrombosis. Therefore, it is very important not to self-medicate, but to seek qualified medical help.

Inflammation of the orbit in the first approximation is associated purulent diseases eye apparatus, epidermis, teeth, paranasal sinuses, jaw. Often the precursors are injuries of the facial skeleton or infections that affect the body.

Can be distinguished the following reasons phlegmon:

• purulent sinusitis, or ethmoiditis (provokes the disease in 70% of cases);
• transfer purulent exudate from foci localized on the epidermis of the human face (furunculosis, barley, erysipelas);
• entry of pathogenic microorganisms into the orbital area;
• dacryocystitis with purulent formations;
• phlegmon of the upper or lower eyelid;
• infected injuries of the eye orbit;
• systemic infections (typhoid, influenza, scarlet fever);
• inflammatory processes in the cavity of the teeth or jaws (periodontal disease, osteomyelitis, caries).

Often pathological process begins with thrombophlebitis of the smallest veins of the orbit. Further, small abscesses will form, which can merge with each other, forming large abscesses. Phlegmon different localization(including an abscess of the orbit) may be the result of the vital activity of streptococcus, coli or staphylococcus. In the area of ​​​​the organs of vision, pathogens move through the facial veins.

Symptoms

Signs of phlegmon usually make themselves felt suddenly. The disease progresses very quickly and becomes acute stage(sometimes only 4-5 hours are enough for symptoms to appear).

The defeat of the orbital tissue proceeds in several successive stages. Each of them is characterized by certain symptoms:

1. Preseptal cellulitis. This is a significant inflammation of the eyelids and skin tissues, which are located in front of the eye relative to the orbit of the eye. At this stage, their painful swelling is observed. At the same time, the mobility of the eyeball does not change, vision is maintained at the same level.
2. Orbital cellulitis. The period of disease progression during which the inflammatory process moves to the tissues posterior region orbital fascia. The visual acuity of the patient gradually decreases, the mobility of the eyeball becomes limited.

In the absence of proper treatment, the disease passes into the stage of subperiosteal abscess. The distance between the bone wall of the orbit of the eye and the periosteum is filled with a purulent mass. Upper eyelid increases in size, exophthalmos develops, vision decreases. At this stage, there is a noticeable displacement of the eyeball to one side.

Phlegmon and cellulitis of the orbit are also accompanied by some common symptoms. They include elevated temperature body, headache different intensity, weakness, decreased body tone.

If the process of formation of a purulent substance occurs only in the orbit, then an abscess is formed, which can open spontaneously through the epidermis or conjunctiva.

There is a possibility of a reverse situation, when the pus does not come out on its own, but the process spreads to the sinuses and the meninges. Sepsis develops, which can cause serious complications and even lead to the death of the patient.

Diagnostics

Any diagnosis of the eye apparatus begins with a detailed collection and analysis of anamnestic information. The doctor will find out if there have been purulent processes affecting the maxillofacial area. Then he will consider clinical picture, perform an examination of the organs of vision using an eyelid lifter and palpate the external tissues.

On the this moment optometrists and ophthalmologists can offer patients following methods diagnosis of phlegmon of the orbit:

• Ophthalmoscopy, or examination eye day by using special device- ophthalmoscope. Allows you to consider any pathology inside the eye, assesses the condition of the optic nerve;
• Visometry - checking the degree of visual acuity. Various tables are used;
• Biomicroscopy. Used to clarify the diagnosis;
• Ultrasound of the eyeball. Used to study physiology internal structure eyes;
• X-ray examination of the eye socket and sinuses. Allows differentiation of phlegmon from other diseases (for example, periostitis). This method can detect the presence of a foreign body in the eye or injury to the eyeball;
• Tonometry, or a technique for measuring intraocular pressure.

As laboratory research patients are prescribed a blood test (general) and seeding for sterility.

Symptoms of eye inflammation are similar to those of many other eye diseases. Therefore, diseases such as dacryocystitis should be ruled out before making a definitive diagnosis. acute course, periostitis of the orbital wall, phlegmon of the eyelid, sarcoma, Quincke's edema, hemorrhage of the retrobulbar type.

Treatment

Patients who are faced with phlegmon of the orbit need competent treatment and hospitalization. Untimely appeal in a medical facility may even pose a threat to the life of the patient. The primary goal of therapy is the elimination of the inflammatory focus in the tissues of the organs of vision. For this purpose, the ophthalmologist prescribes antibiotics related to drugs a wide range actions.

In the case of phlegmon treatment, tetracycline, sulfanilamide and penicillin series. The introduction of drugs can be carried out in a vein, intramuscularly, retrobulbarno or parabulbarno.

The use of drugs is supplemented by trepanation of the orbital wall, puncture and drainage of the paranasal sinuses, and thorough washing of their cavity. If the disease has passed into the stage of formation of fluctuations, then surgery- orbitotomy. After opening, a swab moistened with an antibiotic solution (for example, sodium sulfacyl at a concentration of 30%) is inserted into the canal. During the first 48 hours after the operation, the dressing should be performed 2-3 times a day. If volume purulent discharge decreases, you can replace the tampon once a day.

Together with antibiotic therapy, treatment with anti-inflammatory and analgesic drugs is carried out. The doctor will also prescribe therapy aimed at detoxifying the body.

An additional measure in the treatment of phlegmon of the orbit are installations eye drops antibacterial composition in the area of ​​the conjunctival sac. After some time, they are replaced with special fortified solutions. If there is a possibility of partial opening of the eyelids, then it is recommended to lay ointments based on antibiotics. Medical treatment must be supplemented with physiotherapy (eg, UHF, UVI), which is indicated for all patients. The exception is late stages when there is a softening of phlegmon.

Prevention

As mentioned above, purulent processes in the organs of vision can lead to severe complications. To avoid such consequences will help the correct and timely prevention. Ophthalmologists recommend visiting at least 1-2 times a year. This is especially important for those patients who have suffered or are currently being treated for any chronic or infection eyes, facial skin.

If it gets in the eye foreign body or happened mechanical damage membranes, it is important to conduct antibiotic therapy in order to prevent complications of an infectious nature.

Prevention of phlegmon includes timely detection and thorough sanitation purulent formations in the cavity of the teeth, gums, on the skin or in the structure of the ENT organs.