Panophthalmitis

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1. PANOPHTHALMITIS RAAFI UL BASHEER ZARGAR

2. Table of Contents Introduction EVISCERATION ETIOLOGY CLINICAL FEATURES SIGNS SYMPTOMS COMPLICATIONS TREATMENT 2

3. 1 INTRODUCTION IT’S THE INTENSE PURULENT INFLAMMATION OF THE WHOLE EYEBALL INCLUDING THE TENON’S CAPSULE DEFINITION

4. 2 ETIOLOGY SAME AS INFECTIVE BACTERIAL ENDOPHTHALMITIS

5. INFECTIVE ENDOPHTHALMITIS PERFORATIING INJURIES PERFORATION OF INFECTED CORNEAL ULCER POSTOPERATIVE INFECTIONS FOLLOWING INTRAOCULAR OPERATIONS EXOGENOUS INFECTION VERY RARE ORBITAL CELLULITIS THROMBOPHLEBITIS INFECTED CORNEAL ULCER SECONDARY INFECTIONS METASTATIC ENDOPHTHALMITIS MAY OCCUR RARELY THROUGH BLOODSTREAM CARIES TEETH GENERALISED SEPTICAEMIA PUERPERAL SEPSIS ENDOGENOUS ENDOPHTHALMITIS MODE OF INFECTION

6. INFECTIVE ENDOPHTHALMITIS M.C.-GRAM POSITIVE COCCI Staphylococcus epidermidis Staphylococcus aureus OTHERS Streptococci Pseudomonas Pneumococcus Corynebacterium Propionibacterium acnes Actinomycetes BACTERIAL ENDOPHTHALMITIS RARE CAUSATIVE ORGANISMS Aspergillus Fusarium Candida ,etc. fungal ENDOPHTHALMITIS CAUSATIVE AGENTS

7. 3 CLINICAL FEATURES

8. SYMPTOMS SEVERE OCCULAR PAIN & HEADACHE COMPLETE LOSS OF VISION PROFUSE WATERING PURULENT DISCHARGE MARKED REDNESS & SWELLING OF EYES MALAISE & FEVER

9. SIGNS

10. LIDS MARKED ODEMA HYPERAEMIA EYEBALL SLIGHTLY PROPSED OCCULAR MOVEMENTS LIMITED AND PAINFUL CORNEA CLOUDY ODEMATOUS CONJUCTIVA MARKED CHEMOSIS CILIARY CONGESTION CONJUCTIVAL CONGESTION ANTERIOR CHAMBER FULL OF PUS

11. VISION COMPLETELY LOST NO PERCEPTION OF LIGHT IOC MARKEDLY RAISED GLOBE PERFORATION MAY OCCUR AT LIMBUS PUS COMES OUT IOP FALLS PANOPHTHALMITIS

12. 4 COMPLICATIONS ORBITAL CELLULITIS 01 CAVERNOUS SINUS THROMBOSIS 02 MENINGITIS OR ENCEPHALITIS 03

13. 4 TREATMENT

14. TREATMENT LITTLE HOPE FOR SAVING SUCH AN EYE PAIN & TOXEMIA LEND AN URGENCY TO IT’S REMOVAL ANTI-INFLAMMATORY & ANALGESICS START IMMEDIATELY TO RELIEVE PAIN BROAD SPECTRUM ANTIBIOTICS TO PREVENT FURTHER SPREAD OF INFECTION EVISCERATION PERFORMED TO AVOID RISK OF INTRACRANIAL DISSEMINATION OF INFECTION

15. 5 EVISCERATION IT’S THE REMOVAL OF THE CONTENTS OF THE EYEBALL LEAVING BEHIND THE SCLERA DEFINITION PANOPHTHALMITIS EXPULSIVE CHOROIDAL HAEMORRHAGE BLEEDING ANTERIOR STAPHYLOMA INDICATIONS

16. EVISCERATION SURGICAL PROCEDURE SEPARATION OF CONJUCTIVA & TENON’S CAPSULE CONJUCTIVA INCISED ALL AROUND LIBUS-SPRING SCISSORS UNDERMINING OF CONJUCTIVA & TENON’S CAPSULE ALL AROUND UPTO EQUATOR-BLUNT TIPPED CURVED SCISSORS EPOSES EXTRAOCULAR MUSCLES REMOVAL OF CORNEA CUT MADE AT LIMBUS CORNEA IS EXCISED WITH CORNEOSCLERAL SCISSORS

17. EVISCERATION SURGICAL PROCEDURE REMOVAL OF INTRAOCULAR CONTENTS UVEAL TISSUE SEPARATED FROM SCLERA CONTENTS SCOOPED OUT SEPARATION OF EXTRAOCULAR MUSCLES RECTUS PULLED OUT ONE BY ONE-MUSCLE HOOK 3-O SILK SUTURE IS PASSED NEAR THE INSERTION OF EACH MUSCLE MUSCLE CUT-TENOTOMY INFERIOR & SUPERIOR OBLIQUE MUSCLES ARE HOOKED OUT & CUT NEAR GLOBE

18. EVISCERATION SURGICAL PROCEDURE REMOVAL OF SCLERA SCLERA IS EXCISED LEAVING 3MM FRILL AROUND OPTIC NERVE CLOSURE OF TENON’S CAPSULE & CONJUCTIVA TENON’S CAPSULE SUTURED HORIZONTALLY CONJUCTIVA SUTURED VERTICALLY

19. EVISCERATION SURGICAL TECHNIQUE

20. THANK Y OU!