Orbitaphlegmone is an eye disease that requires emergency medical treatment. If left untreated, orbitaphlegmone can take a fatal course.
What is orbitaphlegmone?
Orbitaphlegmone is an inflammatory disease of the eye socket. The name of the disease is derived, in part, from the medical name for eye socket (orbit). The comparatively rare but severe orbitaphlegmone mainly affects children. In many cases, orbitaphlegmone is accompanied by a strong feeling of illness, which is expressed by fever, among other things. Other symptoms of orbitaphlegmone include severe pain in the affected eye and pronounced swelling of the conjunctiva. Due to pain and conjunctival swelling in the context of orbital naphlegmon, the mobility of the affected eyeball is usually also restricted. In some patients, further symptoms of orbitaphlegmone include visual disturbances; these may be manifested, for example, by blurred vision or the impression of double images. As a rule, orbitaphlegmone is considered a medical emergency.
Causes
Orbitaphlegmon is usually caused by infection with bacteria (often streptococcus). Possible factors that may cause or promote orbitaphlegmone are numerous and vary depending on the individual patient. Triggers of orbital naphlegmone often include prior inflammation of the paranasal sinuses (also known as sinusitis in medical terms). Bacterial sepsis (often referred to as blood poisoning) can also cause orbitaphlegmone. In this case, the bacteria responsible for sepsis spread through the bloodstream and thus enter the orbit, where they then cause inflammatory processes characteristic of orbitaphlegmone. Finally, external injuries to the eye are also possible causes of orbital naphlegmon; corresponding injuries may be caused, for example, by the penetration of foreign bodies.
Symptoms, complaints, and signs
Orbital naphlegmon is characterized by a severe course. Characteristic symptoms include swelling of the conjunctiva (chemosis), swelling of the eyelids, redness of the conjunctiva due to hyperemia, protrusion of the eyeballs, and decreased motility of the affected eyes. In addition, the patient suffers from severe eye pain, loss of visual acuity, and fever. Another symptom is double vision. The loss of visual acuity can lead to blindness. Without treatment, there is a risk of severe complications, some of which may even be fatal. The infection can spread to the neighboring areas of the eyes or even over the entire body. Thus, secondary diseases such as sinus cavernosus thrombosis, meningitis or brain abscess may develop. Sinus cavernosus thrombosis is a life-threatening complication, which, in addition to symptoms in the eyes, is announced by chills, fever, nausea and vomiting. In addition, severe headache, abnormal drowsiness, facial numbness, and seizures occur. Death may occur as a result of cerebral hemorrhage]en or spread of the bacteria through the bloodstream (sepsis). Meningitis is also characterized by similar symptoms. In turn, a brain abscess is characterized by severe headache, neck stiffness, impaired consciousness, and signs of intracranial pressure. Eventually, all of these conditions can lead to sepsis, which is an extraordinarily life-threatening condition. Sepsis is manifested by very high fever, chills, rapid breathing, impaired consciousness, and often ends in fatal circulatory shock.
Diagnosis and course
Because suspected orbital naphlegmon is a medical emergency that requires immediate hospitalization in most cases, diagnostic tests are often performed during hospitalization. With the help of blood tests, the so-called inflammatory parameters (various laboratory values that indicate inflammation in the organism) of an affected person can be determined. Performing a computed tomography (CT) scan can also help confirm the suspected diagnosis of orbitaphlegmone. Symptoms of orbital naphlegmon usually appear suddenly.One of the reasons why orbitaphlegmone is treated as a medical emergency is that the disease leads to death in more than half of the patients within a few weeks if the therapy is not adequate. In the majority of patients, failure to treat orbitaphlegmone results in blindness of the eye affected by the disease. Under early medical care, orbitaphlegmone shows a good chance of recovery.
Complications
In the worst case, orbitaphlegmone results in the death of the affected person. For this reason, this disease requires emergency medical treatment to directly prevent further complications. The affected person primarily suffers from severe swelling directly on the eye. The eyelids and the conjunctiva of the patient swell, so that this also leads to various visual complaints. Those affected also suffer from double vision or veil vision and thus from considerable limitations in everyday life. Furthermore, eye pain also occurs and patients suffer from a high fever. If the disease is not treated early, it can also lead to complete blindness of the patient, which is usually irreversible. Furthermore, without treatment, inflammation of the meninges occurs, which can eventually lead to death if not treated. Inflammation and infections of the nose and mouth can also occur. No complications occur during the treatment itself. With the help of antibiotics, the symptoms can usually be alleviated and the disease fought. A positive course of the disease usually occurs if the disease is treated at an early stage.
When should you go to the doctor?
If there are signs of inflammation of the eye socket, which is called orbital naphlegmon, an immediate visit to the doctor is essential. Without expert medical treatment, this eye condition can end in death. Because orbitaphlegmone primarily affects children, all the more caution is required for any condition affecting the eyes. Orbitaphlegmon, however, occurs relatively rarely. Since several severe inflammatory triggers are possible causes of orbitaphlegmon, prompt action is necessary. Possible triggers for orbitaphlegmone are streptococci, spread sinusitis germs or blood poisoning (sepsis). Penetrated foreign bodies can also trigger orbitaphlegmone. These triggers are not to be trifled with because of the potential health consequences. Because the symptoms of orbital naphlegmon are usually severe, they are often easily recognized. The drama of orbitaphlegmon can be guessed by the child’s parents based on the symptoms. However, young children cannot always express how severe the associated pain is. Because orbitaphlegmon is considered a medical emergency, an emergency physician should be notified immediately if there are signs such as severe conjunctival swelling, limited mobility of the eyeball, or fever. If necessary, those affected should travel with their child to the emergency room of a hospital or to an eye clinic. For children, it is better to see a doctor once too often than once too little.
Treatment and therapy
Proper treatment of orbital naphlegmon is done as an inpatient. Especially in children affected by orbitaphlegmone, intensive medical monitoring may be necessary, depending on the severity of symptoms. An early start of therapy has a decisive influence on the success of the therapy. An important treatment component in the therapy of orbital naphlegmone includes the rapid administration of antibiotics (active substances to fight bacteria). In order for the antibiotics to reach the orbit quickly via the bloodstream, the medication is often administered intravenously (the active ingredient is injected into a vein of the patient). In some cases, surgical treatment of orbital naphlegmon may be necessary. Surgical treatment of orbital naphlegmone is mainly performed in patients with a developed abscess (an encapsulated accumulation of pus) on the eye. If surgery is not performed, there is a risk that the patient may subsequently suffer from meningitis, for example. If orbital naphlegmone is based on sinusitis in an individual case, surgical treatment of corresponding sinuses may be medically necessary.
Outlook and prognosis
Orbitaphlegmone is a dangerous infectious disease of the orbit.The prognosis is positive only if therapy is initiated quickly. The acute disease is visually conspicuous. The affected eye is very painful. It is conspicuously reddened. Therefore, it is highly likely that the affected person will promptly visit an ophthalmologist or a clinic outpatient department. Sometimes both eyes are affected by orbitaphlegmone. In addition, severe accompanying symptoms often occur with this infection. Sufferers have a strong feeling of illness. They have chills or severe headaches. Sometimes fever, nausea and vomiting occur. In other cases, convulsions, delirium or coma may occur. The affected eye is severely red and swollen shut. Orbital naphlegmon is a medical emergency. This is caused by a severe infection behind the eyeball. The longer it takes for the patient to present to an emergency outpatient clinic, the worse the prognosis. There is a risk of developing disseminated thrombophlebitis. This may develop into sinus cavernosus thrombosis. Early treatment with antibiotics and sinus sanitation are important immediate measures. However, these require that the diagnosis be correct immediately. Orbitaphlegmon is particularly common in tropical countries. Unfortunately, prompt medical care is not available everywhere.
Prevention
Consequential damage due to orbitaphlegmone should be prevented primarily by early therapy. Prevention of injuries to the eye that can lead to orbitaphlegmone is limited; however, appropriate protective equipment may be important for individuals with an increased risk of injury at work or during leisure time. Finally, physicians recommend early visits to the doctor if sinusitis or possible sepsis is present to limit the risk of subsequent orbitaphlegmone.
Follow-up
After the diagnosis and treatment of orbital naphlegmon, affected individuals need to protect their orbits especially from influences such as bacteria and wind. The affected person should avoid sports to prevent the orbital naphlegmon from spreading to other regions of the body. People suffering from serious illnesses or immune deficiency are particularly susceptible to secondary infections. Special care must be taken here. Wearing an eye patch can also protect against secondary infection. In addition, the eye patch can protect the affected person from spreading the disease and thus infecting other parts of the body. This can prevent the occurrence of further symptoms. Affected persons should find the exact cause of the disease. For example, people who frequently suffer from barleycorns due to their profession and thus suffer from orbital aphlegmon should consider changing their profession. If the disease has progressed to the point where blindness of both eyes occurs, it is imperative that a psychologist be consulted. The psychologist can help the patient to cope with the loss of vision and to deal with it appropriately. In the case of children with the disease, parents should ensure as far as possible that the child does not touch its eyes with its hands. Above all, strict personal hygiene and avoidance of particularly sweet, sour and spicy drinks and foods apply.
This is what you can do yourself
If orbitaphlegmon is suspected, the doctor must be consulted. After diagnosis, it is important to protect the orbit from external influences such as wind and bacteria. Treatment with antibiotics can be supported by rest. The patient should not do any sports for the first few days and ensure that the orbital naphlegmon does not spread to other parts of the body. People with an existing immune deficiency or other serious illnesses that favor secondary infections are particularly at risk. If necessary, the wearing of an eye patch can also be useful. This prevents the infected region from becoming further inflamed and thus causing further discomfort. Finally, it is important to determine the cause of the condition. Individuals who repeatedly suffer from orbital naplegmon after occupational contact with barley seeds must consider a change of occupation. In the case of a severe course with blindness in one or both eyes, psychological counseling is also useful. The patient can also exchange ideas with other affected persons in order to cope with the loss of vision.Parents of affected children should take care that the child does not touch the inflamed eye. Strict personal hygiene applies and, if necessary, a change in diet. Particularly spicy, acidic, or sweet foods and beverages should be avoided….
