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Abstract: This patient presented to our hospital with swollen eyelids and painful pressure for 3 days, which worsened, and after relevant examinations, was diagnosed with endophthalmitis, commonly known as needle’s eye, which is a common ophthalmic condition with causative factors including staying up late, excessive eye use, irregular diet or preference for spicy and stimulating foods. After standard medication and physical therapy, the patient’s painful symptoms subsided and the inflammatory swelling largely subsided.
Basic information】Male, 38 years old
Disease Type】Endophthalmitis
Hospital】Xinxiang City Central Hospital, Henan Province
Date of Consultation】August 2020
Treatment plan】Topical medication (levofloxacin eye drops, oxyfloxacin eye ointment) + physical therapy (local hot compresses)
Treatment period】2 weeks of outpatient treatment, regular follow-ups
【Treatment effect】 Inflammatory swelling subsided and completely improved
I. Initial consultation
The patient came to the clinic three days ago with swelling of the right eyelid, and the pain on pressure was obvious and continued to worsen. The night before the disease, he had a dinner with friends and ate barbecue, and then early the next morning he found that the upper eyelid of his right eye was swollen, so he thought it was a “needle’s eye” from the fire and ignored it. After waiting for 3 days, the swelling did not improve and became even worse, so he went to our hospital for consultation. After preliminary examination, we found that the patient had normal vision, no diplopia, no painful eye rotation, and only mild pressure pain in the swollen upper eyelid, and when the eyelid was opened, the inner surface of the eyelid was red and swollen.
II. Treatment history
The patient was then given a detailed ocular examination, which revealed swelling of the upper eyelid with slight difficulty in opening the eyes, accompanied by mild photophobia and lacrimation. The examination revealed that the patient’s upper eyelid was swollen on the surface, but there were no obvious pus spots, and turning the eyelid over revealed that the inner surface of the patient’s eyelid was significantly swollen, with white pus spots visible on the most prominent part of the swelling, which is a manifestation of endophthalmitis.
The first is that the patient is busy at work, staying up late to catch up on projects, which leads to irregular work and rest, eating takeout for a long time, which is generally greasy and spicy, and eating barbecue and drinking at night before the onset of the disease, which became the last straw that broke the camel’s back. This is a typical case of inflammation of the lid gland caused by long-term bad habits. After communicating with the patient, the treatment plan was formulated as follows: levofloxacin eye drops, and oxyfloxacin eye ointment applied to the eye, along with daily hot towel compresses for the eye. The patient was also advised to pay attention to healthy eye use, regular work and rest schedule, pay attention to more rest, avoid staying up late, pay attention to avoid spicy and stimulating food, quit smoking and alcohol during the treatment period.
Third, the effect of treatment
After using these medications and improving lifestyle habits, the patient reported that the eyelid swelling began to decrease on the third day after treatment. At the follow-up visit one week after treatment, the patient was able to open the eyes normally, and the symptoms of photophobia and tearing had completely disappeared, and the swelling had decreased by half compared to the first visit. At the follow-up visit 2 weeks after treatment, the eyelids were completely normal and no residual small cysts were found on palpation of the eyelids, so the patient’s endophthalmitis was basically cured.
IV. Notes
I am sincerely pleased that the patient’s endophthalmitis was effectively treated. It is important to remind patients to develop good lifestyle habits, to stop smoking and drinking, to avoid prolonged eye use, and to avoid junk food and spicy stimulating foods, which will most likely reduce the likelihood of a recurrence of endophthalmitis. Patients are also advised to keep an eye on their eyes and to go to the hospital for a checkup if they experience dry eyes, astringent eyes, red eyes, and swollen eyelids to determine if blepharitis has returned.
V. Personal Insights
Endophthalmitis is a common ophthalmologic condition that is caused by an obstruction of the sebaceous glands or lid glands in the eyelids, followed by infection. The disease is indeed self-healing, which can cause many people to have the same misconceptions about treatment as the patient in this article, thinking that the disease will heal on its own without treatment.
However, it is important to note that not all blepharitis can heal completely on its own. If this patient is not treated actively, it may worsen later and even form a cyst, clinically known as a blepharocyst, which will not subside on its own and will not subside with medication, and can only be treated with outpatient surgery.
Therefore, it is important to seek medical attention and actively participate in treatment when the eyes become swollen and uncomfortable, so that the cyst can be effectively avoided and the pain of the disease can be increased.