Phthisis Bulbi : Causes, Symptoms, Stages, Prognosis and Treatment

Phthisis bulbi is an end-stage eye disease characterized by soft, shrunken, disorganized and atrophic eye. It is the complication of other eye diseases. Reduced aqueous humor production in phthisis bulbi lower the intraocular pressure of eyeball.

Phthisis Bulbi : Causes, Symptoms, Stages, Prognosis and Treatment
Phthisis Bulbi 
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Causes of Phthisis Bulbi

If many eye diseases are not get proper treatment for long periods of time, then it may result in phthisis bulbi. Any of the following conditions can lead to the development of phthisis bulbi-
  • Chronic inflammatory conditions like uveitis, keratitis, Endophthalmites.
  • Penetrating corneal injury and corneal ulcer
  • Blunt trauma
  • Post-surgical (cataract surgery)
  • Infections
  • Chronic Retinal detachment (separation of  neurosensory later of retinal from pigment epithelium)
  • Tumors e.g. Retinoblastoma (in children)

Signs and Symptoms

Following Symptoms may be present in a patient of phthisis bulbi -
  • Loss of visual acuity
  • Redness
  • Photosensitivity
  • Pain and tenderness in and around the eye.
  • Perception of light is absent
  • Eye become a small, shrunken and square shape
  • Lower intraocular pressure
  • Folding of sclera because sclera become thickened
  • Sometimes bone has formed an the eye because of metaplasia
  • Calcification of lens, retina, and cornea is seen in histopathological examination.

Stages of Phthisis Bulbi

Development of phthisis bulbi can be divided into three stages-

Stage 1: Atrophic Bulbi without Shrinkage

Normal functions of the eye are lost at this stage. Vision is almost completely lost, the shape of eyeball remains normal and atrophic changes begin to occur.

Stage 2: Atrophic Bulbi with Shrinkage

In this stage, changes occur due to the destruction of the cilliary body. Eye become small, atrophic and quadrilateral in shape.

Stage 3: Atrophic Bulbi with Disorganization

This is the last stage and also known as phthisis bulbi. Above mentioned signs and Symptoms develop at this stage.

prognosis and Treatment

As earlier mentioned it is the end stage of eye diseases, therefore, the prognosis of phthisis bulbi is very poor and only treatment options available is enucleation and implantation of the prosthesis.

Differential Diagnosis

Atrophic bulbi should be differentiated from phthisis bulbi.

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