Monday, 6 October 2014

Endogenous Endophthalmitis in a 15 day old baby

Endogenous endophthalmitis is an eye infection where it enters the eye via the blood stream from a focus of infection somewhere in the body. Babies with neonatal endogenous endophthalmitis can go into phthisis i.e. the eye becomes small and soft with no vision. In October 2012, the David Brown Children's Eye Care Centre at LVPEI Vijayawada's Kode Venkatadri Chowdary Campus saw a 15 day old baby of Annaparedy Sri Ravamma with this dreadful infection in both eyes, with the left eye being worse. The baby had severe sepsis (infection in blood) which was resistant to some of the higher antibiotics. Our team followed our protocol of managing such patients religiously. The anesthesia team took a risky decision to administer general anesthesia and surgery was performed. Over a period of few months, the infection in both the eyes resolved completely and the eyes was salvaged. 

Now the cornea developed opacity (white patch), so dense that a corneal transplantation surgery was advised. But the family went away and turned up for follow-up only after several months. Surprisingly the corneal opacity had cleared completely though the child had now developed cataract. It was a fairly complicated case where the pupil was completely closed due to previous infection and the iris was gummed down on the lens. Dr Niranjan Pehere went ahead with the surgery. Cataract was removed and an intraocular lens was implanted. Following the surgery, the child is doing very well and his functional vision is like any other child of his age.

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