PANOPHTHALMITIS

It is an intense purulent inflammation of the whole
eyeball including the Tenon’s capsule. The disease
usually begins either as purulent anterior or purulent
posterior uveitis; and soon a full-fledged picture of
panophthalmitis develops, following through a very
short stage of endophthalmitis.
Etiology
Panophthalmitis is an acute bacterial infection.
Mode of infection and causative organisms are
same as described for infective bacterial
endophthalmitis (page 150, 151).
Clinical picture
Symptoms. These include:
Severe ocular pain and headache,
Complete loss of vision,
Profuse watering,
Purulent discharge,
Marked redness and swelling of the eyes, and
Associated constitutional symptoms are malaise
and fever.
Signs are as follows (Fig.7.20):
1. Lids show a marked oedema and hyperaemia.
2. Eyeball is slightly proptosed, ocular movements
are limited and painful.

3. Conjunctiva shows marked chemosis and ciliary
as well as conjunctival congestion.
4. Cornea is cloudy and oedematous.
5. Anterior chamber is full of pus.
6. Vision is completely lost and perception of light
is absent.
7. Intraocular pressure is markedly raised.
8. Globe perforation may occur at limbus, pus comes
out and intraocular pressure falls.
Complications include:
Orbital cellulitis
Cavernous sinus thrombosis
Meningitis or encephalitis
Treatment
There is little hope of saving such an eye and the
pain and toxaemia lend an urgency to its removal.
1. Anti-inflammatory and analgesics should be
started immediately to relieve pain.
2. Broad spectrum antibiotics should be
administered to prevent further spread of infection
in the surrounding structures.

3. Evisceration operation should be performed to
avoid the risk of intracranial dissemination of
infection.