my patients eye diappeared

i took care of an elderly male patient on admission his main complain was his legs  and his left eye had minimal whitish discharge  and by the 3rd day his eyeball was reddish and he seemed like he was crying beacause he usually had tears on his eye corners  he was seen by an opthalmologist and was treated  tobramycin eye drops and cyclogel however after a week when i saw him again his eyes was slowly melting, he had corneal abrasion and vitreous hemorrhage, and after 3 days his eyes was totally gone. did he get the right treatment? beacause after his last diagnosis no new eyedrops were prescribed  and antibiotic were just added. pls advice.

[John C Hagan III, MD, FACS, FAAO]

Nothing in this story make sense. Tobramycin is an antibiotic. cyclogel is a dilating medication. Its not used to treat infections.   Few things will progress that fast to lost eyes.

You need to discuss the case with the ophthalmologist and then present the case at grand rounds for discussion by all the medical attending.

JCH MD

[kaykay1004]

My 93 yr. old mom was given Tobradex for an eye infection and has not been the same since.  She had no med. hist. other than moderate dementia.  After the 1st dose of tobradex, she became difficult to arrouse and because of this, slightly dehydrated.  She also had immediate increased difficulty in swallowing.  Approx. 3 weeks after dc of ointment, she was in the hospital due to build up of upper resp. fluid.  She pulled thru and is again home, but now needs a suction pump and has not returned to her ability to swallow pre-tobramax.  Anyone else with a similar story?

[John C Hagan III, MD, FACS, FAAO]

Tobradex would not cause those types of problems. Every day in the life of a 93 year old is precarious and bad things may happen. The relationship is likely coincidental

JCH MD