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How is eye infection in diabetics treated ?

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Posted on Tue, 8 May 2012
Question: Hello Doctor, my father, 59yrs old, a known diabetic and hypertensive with CAD and severe LV dysfunction on regular dialysis.
Recently he has got eye infection. We have consulted opthalmologist and he has removed the puss and sent it for culture and sensitivity test. Reports says the following:
Nature of Specimen : Vitreous and AC Tap
KOH (Vitreous and AC Tap): No Organisms seen.
Gram Stain (Vitreous and AC Tap): Polymorphs plenty/HPF, Gram negative bacilli 0-5/HPF, Gram positive cocci in pairs 0-1/HPF seen.
Culture : Klebsiella species.
Antibiotic Susceptability:
Senstive :
Amikacin
Ciprofloxacin
Ofloxacin
Gatifloxacin
Moxifloxacin
Ceftazidime
Co Trimoxazole
Chloramphenicol

Please suggest if this infection can be cured using antibiotics or it needs surgery.
Earlier before the report opthamologist has removed the puss and mentioned the risk of eviscerutum.
We have consulted diabetologist for his sugar levels control.
He has seen the report and advised the following medicines:
Monocef 2gm Inj IV - OD
T. zanocin 200 - (8am -8pm)

Today, we have met the opthamalogist again. He has mentioned panopthalmin.
Please let me know if there is any advanced technology available to cure this disease or
is eviscerutum only option available?
doctor
Answered by Dr. N. K. Misra (14 hours later)
Hello,

Thanks for the query.

The situation as I can gather from your statement is very grim. In such cases along with vitreous tap we give a combination of following drugs*

1. Vancomycin 500 mg diluted in 10 ml . Take .2 ml and dilute to 1 ml and take .1 ml of this.

2. Cefa(fortem) 250 mg dilute in 5ml. Take .1 ml and dilute to .2 ml and Take .1 ml of this

3. Add .1 ml Decadron to this.

(*Kindly ask your ophthalmologist to prepare this.)

This is given as an intreavitreal injection. Once evisceration is being contemplated that means these are desperate situations which require desperate measure. And once the eye response to 1st injection is studied this is repeated after 5 -7 days. This intra vitreal injection is more effective than a long term systemic medicaton.

No advanced therapy is available as for now. The best bet under the given circumstances is the intra vitreal injection (mentioned above) which should be started under expert supervision as soon as possible.

Control of diabetes is extremely important.

Feel free to contact us regarding any further queries.

Regards,

Dr. N.K. Misra
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. N. K. Misra

Ophthalmologist

Practicing since :1977

Answered : 1281 Questions

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How is eye infection in diabetics treated ?

Hello,

Thanks for the query.

The situation as I can gather from your statement is very grim. In such cases along with vitreous tap we give a combination of following drugs*

1. Vancomycin 500 mg diluted in 10 ml . Take .2 ml and dilute to 1 ml and take .1 ml of this.

2. Cefa(fortem) 250 mg dilute in 5ml. Take .1 ml and dilute to .2 ml and Take .1 ml of this

3. Add .1 ml Decadron to this.

(*Kindly ask your ophthalmologist to prepare this.)

This is given as an intreavitreal injection. Once evisceration is being contemplated that means these are desperate situations which require desperate measure. And once the eye response to 1st injection is studied this is repeated after 5 -7 days. This intra vitreal injection is more effective than a long term systemic medicaton.

No advanced therapy is available as for now. The best bet under the given circumstances is the intra vitreal injection (mentioned above) which should be started under expert supervision as soon as possible.

Control of diabetes is extremely important.

Feel free to contact us regarding any further queries.

Regards,

Dr. N.K. Misra