China
Africa
Explore chapters and articles related to this topic
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
Traumatic penetration of the cornea or sclera leads to the introduction of bacteria, usually staphylococci, streptococci, or Gram-negative rods. Introduction of this exogenous infection leads to the inflammation of the internal eye tissues (endophthalmitis) or all the layers of the eye (panophthalmitis). Alternatively organisms may reach the eye via the bloodstream from a distant source of infection – metastatic endophthalmitis, e.g. lung abscess or diverticular abscess.
Clinical Toxicology of Snakebite In Africa and The Middle East / Arabian Peninsula
Published in Jürg Meier, Julian White, Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
Venom can be “spat” into the eyes, and onto nasal and buccal membranes from a distance of several metres. There is intense pain in the eye, blepharospasm, palpebral oedema and leucorrhoea. Corneal erosions can be seen by slit lamp or fluorescein examination in more than half of those spat at by N. nigricollis. Rarely, venom is absorbed into the anterior chamber, causing hypopyon and anterior uveitis. Secondary infection of corneal abrasions may lead to permanent blinding opacities or panophthalmitis. Venom absorbed through the conjunctivae may spread by the lymphatics and cause transient facial nerve paralysis.
Classification of uveitis
Published in Gwyn Samuel Williams, Mark Westcott, Carlos Pavesio, Bushra Thajudeen, Practical Uveitis, 2017
Gwyn Samuel Williams, Mark Westcott
Just as inflammation can spread from one part of the uveal tract to another it can also spread inwardly and outwardly. To complicate things further the term ‘posterior uveitis’ is imprecisely and confusingly used to describe inflammation anywhere in the back of the eye and can occur with or without involvement of the choroid. For example, inflammation primarily involving the retina, retinitis, can occur either in isolation, without involvement of the choroid, or secondarily to inflammation in the choroid. Similarly, primary inflammation of the choroid can spread to involve the retina secondarily to cause a retinitis. The same is true for posterior spread to involve the outer coat, the sclera. Endophthalmitis is a condition where the entirety of the inside of the eye is inflamed such that the layer most affected cannot be discerned. In this condition the outermost coat, the sclera, is not yet heavily involved. Panophthalmitis is where the inside of the eye and all three coats are inflamed. Although strictly speaking the uveal tract is one distinct layer of the eye, the term ‘uveitis’ rather confusingly is often applied to any intraocular inflammation, in much the same way as ‘America’ can be a term applied to either the country or the continent.
Clinical Features and Mortality of Endogenous Panophthalmitis in China: A Six-Year Study
Published in Seminars in Ophthalmology, 2022
Meng Qi, Lei He, Pengfei Zheng, Xiangyu Shi
Endogenous endophthalmitis (EE), also termed metastatic endophthalmitis, results from the hematogenous spread of pathogens from a remote source via the blood-retinal barrier into the eye. It is a life- and vision-threatening disease often associated with several immunosuppressive conditions.1–4 Cases and studies have been reported globally,4–10 revealing possible clinical features, treatment modalities, and EE outcomes. However, sporadic extreme cases were found at our eye center. Besides the infection of the anterior and posterior segments, orbital structures were also severely involved, indicated by marked lid edema and chemosis, proptosis, and ocular movement limitations. According to the clinical classification of EE by Greenwald,11 the diagnosis of endogenous panophthalmitis (EP) was made. Literature on EP remains scarce. Despite early diagnosis and treatment, most globes were lost, requiring evisceration or enucleation, with a significant mortality rate. There are not yet any guidelines on the management of this disease.11–14
How to best manage a patient with Bacillus endophthalmitis: current insights
Published in Expert Review of Ophthalmology, 2021
Amin Ahmadi, Mohammad Soleimani, Ali A. Haydar, Shima Moslemi Haghighi
Endophthalmitis is a highly devastating intraocular infection that frequently leads to blindness. If not treated adequately, endophthalmitis can progress to panophthalmitis – necessitating evisceration or enucleation of the eye. Endophthalmitis can be categorized into postoperative, post-traumatic, or endogenous [1]. In a major review on the microbial causes of endophthalmitis, 85.1% of pathogens were identified as gram-positive bacteria, 10.3% gram-negative, and 4.6% fungi [2]. Overall, Staphylococcus epidermidis is the most common identified pathogen [2]. Acute postoperative endophthalmitis and post intravitreal endophthalmitis are most caused by Staphylococcus epidermidis, whereas Staphylococci and Bacillus cereus are the most common cause of posttraumatic endophthalmitis [1,3,4]. The prevalence of posttraumatic endophthalmitis ranges from 0.9% to 11.9% [5–8], with much higher figures in case of intraocular foreign body (IOFB) injuries, 6.9% to 30% [9–11]. Endogenous endophthalmitis is mainly caused by Staphylococcus aureus and Streptococci when associated with endocarditis, and by Klebsiella pneumoniae when associated with liver abscess. Endogenous fungal endophthalmitis is common in hospitalized patients, mainly due to Candida albicans [1].
Endophthalmitis Progressing to Panophthalmitis: Clinical Features, Demographic Profile, and Factors Predicting Outcome
Published in Seminars in Ophthalmology, 2018
Rajeev R. Pappuru, Vivek Pravin Dave, Avinash Pathengay, Sankeert Gangakhedkar, Savitri Sharma, Raja Narayanan, Mudit Tyagi, Andrzej Grzybowski, Taraprasad Das
In most case reports and short series in literature on management of panophthalmitis, the globe was lost requiring evisceration or enucleation.3–7,10,11 none of the literature have a mention of administration of systemic steroids under cover of systemic antibiotics. In the current study, administration of systemic steroids had a very high odds of a favorable final outcome. As panophthalmitis is a very virulent presentation of infection, it has a high quantum of inflammation. We propose that simultaneous control of the inflammation is highly desirable in this condition and would warrant the administration of systemic steroids. For most of the series described, the commonest organism was Bacillus and few had Gram-negative organisms like E. coli and Klebsiella. In contrast our series had a majority of cases being Gram-positive cocci. The difference in virulence of the organisms in the other reports and in our series possible could also account for a better outcome in our cases.