Symptoms of an eye abscess

Basically, signs of inflammation occur with an abscess on the eye. The skin is supplied with more blood and thus becomes reddened. In the area of the abscess there is also a swelling, which is shown by a clear protrusion of the reddened, overheated skin to the outside.

A feeling of tension develops. If you touch the skin above the abscess, you can feel the movement of the pus, the fluctuation. Within the abscess, throbbing pain continues to occur at the affected area.

The swelling and the pain can also affect the closure of the eyelid. In severe cases, in addition to these localized symptoms, so-called systemic symptoms can also occur, i.e. symptoms that indicate involvement of the entire body. These are mainly understood to be poor general condition and fever.

If these symptoms occur, a doctor must always be consulted immediately, as they indicate a severe course of the infection. The same applies if warning symptoms appear as signs of inflammation in the eye socket or an abscess in this area. These are: Fever, severe pain in the eye, sudden deterioration of vision, protruding eyeball (exophthalmos) and paralysed eye muscles with malposition of the eye (ophthalmoplegia).

Diagnosis

An examination of the inflammation values in the blood and the preparation of blood cultures can reveal systemic involvement. If the symptoms described by the patient lead to suspicion of an inflammation or an abscess in the area of the eye socket, the eye must be examined in detail. The physician then pays attention to redness and swelling (edema) around the eyeball, protrusion of the eyeball and malposition of the eye.

The above-mentioned blood tests are also used in this case. If the suspicion persists, a CT examination of the head may be necessary. During this examination, three-dimensional images are produced using X-rays, on which the spread of the inflammation into the depths, the involvement of surrounding structures and the location of any abscesses can be assessed.

The treatment of an abscess on the eye

The principle “ubi pus, ibi evacua” (“Where there is pus, empty it”) applies. This means that an abscess must always be opened surgically. In the outer area of the eye, this is relatively easy.

A small so-called stab incision is made, i.e. a canaliculus is created through which the pus is pushed outwards. The abscess cavity can then be rinsed with disinfectant solutions or common salt. In the case of deep abscesses, a disinfectant insert is inserted into the abscess cavity to allow the pus to drain.

. Unfortunately, a general anaesthetic is often necessary for this small operation, as a local anaesthetic carries the risk of bacteria in the tissue. An additional antibiotic treatment of the abscess does not necessarily have to be carried out.

In case of systemic symptoms or abnormal blood values, however, this should be carried out. Often it is also used preventively after the abscess has been split. The situation is somewhat different in the case of an abscess that occurs in the area of the eye socket.

In this area there is the danger of spreading to the brain. To avoid this, treatment must be carried out as soon as possible. First of all, the affected person is admitted to hospital as an in-patient.

The first therapeutic step is the administration of antibiotics, at least initially mostly through a vein. If the therapy is sufficiently effective, it is usually continued until there is no fever for a few days. An existing abscess also requires surgical intervention to drain the pus from the inaccessible area of the orbit. This is performed under general anaesthesia either directly on the eye or indirectly via the upper jaw. During the inpatient stay, the function of the eyes is also closely monitored.