Phthisis Bulbi - Symptoms, causes and treatment

Phthisis bulbi is severe damage to the eyeball which is the end-stage of eye damage. This condition can be caused by various disorders of the eye, such as severe infections, injuries, inflammation, tumors, blood vessel disorders, and complications due to eye surgery

Phthisis bulbi can be characterized by a decrease in the size of the eyeball, changes in the arrangement of the eye, and a decrease or even loss of vision function or blindness. The symptoms will get worse over time.

Phthisis bulbi cannot be cured, but the underlying disease can be treated to prevent the occurrence of phthisis bulbi. If phthisis bulbi has occurred, treatment will generally not restore vision function, but can relieve symptoms, prevent complications, and improve the appearance of the eye that has been damaged.

Causes of Phthisis Bulbi

Phthisis bulbi can occur due to various disorders and diseases of the eye. The disorder can be hereditary or occur on its own. Some eye disorders that can cause phthisis bulbi are:

• Infections

  Severe eye infections, such as keratitis, endophthalmitis, and panophthalmitis, can cause serious eye damage if not treated properly.

• Chronic retinal detachment

  Retinal detachment is a detachment of the retina from the choroid. This condition can cause blood flow to the eye to be disrupted, resulting in insufficient intake of the eye. Over time, retinal detachment will cause phthisis bulbi.

• Complications due to eye surgery

  One of the complications of eye surgery is eye tissue damage, and this is at risk of causing phthisis bulbi.

• Chronic inflammatory disease

  Long-term inflammation of the eye, such as uveitis, can cause eye problems that can progress to phthisis bulbi. Another disease that can cause inflammation of the eye is an autoimmune disease.

• Persistence of hyperplastic primary vitreous (PHPV)

  PHPV is a developmental disorder of the eye with characteristic symptoms in the form of leukocoria (white shadow on the cornea), micropthalmia (ball small eyes), and cataracts. This disease is caused by a genetic disorder. Symptoms of this disease will appear 1-2 weeks after birth.

• Malignant tumors

  Malignant tumors of the eye can also cause phthisis bulbi. One of them is retinoblastoma. This malignant tumor often occurs in children.

• Injuries to the eye

  Severe eye injuries, such as open/closed globe injuries, and injuries to the eye from alkaline chemicals can cause damage to the eye that triggers occurrence of phthisis bulbi.

Phthisis Bulbi Symptoms

Phthisis bulbi which is the final phase of chronic eye damage. In this phase, there will be a decrease in the volume of the eyeball, a decrease in the size of the eyeball (axial length), and a thickening of the sclera (the white part of the eye).

When the eye reaches this phase, the following complaints and symptoms may occur:

• Decrease and even loss of vision function
• New blood vessels appear on the iris (iris)
• Clumping of calcium or bone growth in the eye
• Pain in the eye

When to see a doctor

To prevent phthisis bulbi, check with your doctor if you experience complaints or eye problems. You also need to see a doctor if there is a decrease in visual function and the complaints or symptoms that are felt in the eyes are getting worse.

Phthisis Bulbi Diagnosis

To diagnose phthisis bulbi, the ophthalmologist will conduct questions and answers regarding the complaints and symptoms experienced by the patient, history of eye injury, medical procedures that have been performed on the eye, and other medical history related to the eye.

After that, the doctor will perform a physical examination to assess the patient's visual ability, as well as ophthalmoscopy, slit lamp examination, and tonometry examination of eye pressure.

To confirm the diagnosis of phthisis bulbi, the doctor may also suggest supporting examinations, such as:

• CT scan or MRI of the eye, to see tumors and damage to the eye
• Biopsies of the eye, to see changes and growth of cells and tissues in the eye

Phthisis Bulbi Treatment

Phthisis bulbi treatment is not to cure or restore vision, but to relieve symptoms, prevent complications, and improve the appearance of damaged eyes. Some of the treatments that can be done are:

Medications

Medication is given to treat the disease that causes it, such as antibiotics to treat bacterial eye infections. Medication is also given to treat symptoms, such as painkillers to relieve pain.

Operation

Surgery is required if the damage to the eye is extensive and severe. The types of surgery that can be performed are enucleation (removal of the eyeball) and insertion of a prosthetic (artificial eye) to improve the appearance of the eye.

Phthisis Bulbi Complications

Phthisis bulbi complications are visual disturbances or permanent blindness. Since this condition can be caused by various diseases of the eye, other complications that occur can also vary, depending on the underlying disease.

Phthisis Bulbi Prevention

The best way to prevent phthisis bulbi is to treat it as early as possible when eye problems occur.If there has been damage to the eye due to chronic disease in this organ, ask an ophthalmologist about the treatment that needs to be done to prevent phthisis bulbi.