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Phthisis bulbi - External and Internal Eye
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Phthisis bulbi - External and Internal Eye

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Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
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Synopsis

Phthisis bulbi is the end-stage ocular response to trauma and/or severe ocular disease. The presentation is that of a very soft, atrophic, blind, and shrunken eye with disorganization of the intraocular structures. These eyes usually do not have pain. However, if pain is present, it can range from very mild irritation to extreme, nearly 10/10, pain. Patients can be asymptomatic for years and then suddenly develop intense, unremitting pain leading to the need for medical and/or surgical intervention.

Codes

ICD10CM:
H44.529 – Atrophy of globe, unspecified eye

SNOMEDCT:
4229009 – Phthisis bulbi

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Although phthisis bulbi is a physical finding, it is very important to determine not only the underlying cause but what else might be present. A careful history and a careful slit lamp exam will nearly always lead to the underlying cause. However, such eyes are famous for harboring late onset tumors. Retinoblastoma, bony tumors (eg, osteoma), osteogenic sarcoma, and uveal melanoma have all been found in eyes with phthisis bulbi.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 10/24/2018
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Phthisis bulbi - External and Internal Eye
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Phthisis bulbi : Eye pain, Blindness, Corneal focal white infiltrate, Enophthalmos
Clinical image of Phthisis bulbi
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