Nursing Case Study 1 Tobramycin

In this case, the patient is a 75-year old white male. He recently underwent cataract surgery on his right eye (OD) and was given three post-operative topical ophthalmic drugs: prednisolone, tobramycin and ketorolac drops, with which he used all with good compliance. These three drugs are prescribed after cataract surgeries to help the recovery process and to help fight against infections and inflammation. Prednisolone is a corticosteroid, which works to prevent the release of substances in the body, such as leukocytes, that cause inflammation. It does this by binding to glucocorticoid receptors to either activate or influence the biochemical behavior of most inflammatory cells.1 Tobramycin is an antibiotic, which works to fight off bacteria

Endophthalmitis is severe inflammation of the intraocular cavities, such as the aqueous and vitreous chambers, ~70% of the time caused by an infection from a complication of an intraocular surgery. It can quickly begin to damage much of the eye, so time is of the essence when deciding on treatment options to ensure the preservation of the patient’s vision. There are two types of endophthalmitis: exogenous and endogenous. Exogenous is caused by a trauma or surgery. Acute post-operative endophthalmitis is the most common type, which is what is seen in our patient. Statistics show that between 0.072% and 0.13% of acute endophthalmitis is caused by cataract surgeries. On the other hand, endogenous endophthalmitis is quite uncommon – only 5 in 10,000 cases. Blood-borne organisms reaching the eye via the blood-ocular barrier are what cause the infection. It is mostly seen in patients who already have complications with their immune systems, such as drug users, alcoholics, patients undergoing chemotherapy or have had an organ transplant, and patients with diseases like AIDS or diabetes,

This is done to remove any blood or debris from the infection and inflammation that is blocking the patient’s vision because the eye alone cannot clear out the infection and there is a serious risk of permanent damage and vision loss in the right eye.7 However, usually only the core of the vitreous cavity is removed. This is to avoid scraping at the periphery of the vitreous cavity, which contains the retina, which could be damaged in the process. Also, keeping some of the body’s own components allows a smaller risk of various ocular diseases, such as glaucoma and macular degeneration, because some of the body’s own inflammatory factors like vitamin C will