Phthisis Bulbi - Symptoms, causes and treatment

Phthisis bulbi is damage severe on the eyeball is the final phase (end-stage) from eye damage. This condition can be caused by various eye disorders, such as severe infections, injuries, inflammation, tumors, vascular disorders, and complications from surgery eye.

Phthisis bulbi can be characterized by a decrease in the size of the eyeball, changes in the arrangement of the eye, and a decrease or even loss of vision function or blindness. Symptoms will get worse over time.

Phthisis bulbi cannot be cured, but the underlying disease can be treated to prevent phthisis bulbi from developing. If phthisis bulbi has occurred, treatment will generally not restore visual function, but can relieve symptoms, prevent complications, and improve the appearance of the eye that has been damaged.

Symptoms of Phthisis Bulbi

Phthisis bulbi which is the final phase of chronic eye damage. In this phase there will be a decrease in the volume of the eyeball, shrinkage of the size of the eyeball (Fig.axial length), and thickening of the sclera (white part of the eyeball).

When the eye reaches this phase, the following complaints and symptoms may occur:  

  • Decrease or even loss of visual function
  • The appearance of new blood vessels on the iris (iris)
  • Calcium clumps or bone growth in the eye
  • Pain in the eyes

When to go to the doctor

To prevent the occurrence of phthisis bulbi, check with your doctor if you experience complaints or eye problems.

You also need to see a doctor if there is a decrease in visual function and the complaints or symptoms that are felt in the eyes are getting worse.

Causes of Phthisis Bulbi

Phthisis bulbi can occur due to various disorders and diseases of the eye. The disorder can be hereditary or occur on its own. Some eye disorders that can cause phthisis bulbi are:

  • Infection

    Severe eye infections, such as keratitis, endophthalmitis, and panophthalmitis, can cause serious damage to the eye if not treated properly.

  • Chronic retinal detachment

    Retinal detachment is the detachment of the retina from the choroid. This condition can cause blood flow to the eye to be disrupted, so that the eye lacks nutritional intake. Over time, retinal detachment will cause phthisis bulbi.

  • Complications due to surgery eye

    One of the complications of eye surgery is damage to eye tissue, and this is at risk of causing phthisis bulbi.

  • p . diseaseinflammation chronic

    Long-term inflammation of the eye, such as uveitis, can cause eye irritation that can progress to phthisis bulbi. Another disease that can cause inflammation of the eye is an autoimmune disease.

  • Persistence hhyperplastic primary vitreous (PHPV)

    PHPV is a developmental disorder of the eye with typical symptoms of: leukocoria (white shadow on the cornea) microphthalmia (small eyeball), and cataracts. This disease is caused by a genetic disorder. Symptoms of this disease will appear 1-2 weeks after birth.

  • Tumor malignant

    Malignant tumors of the eye can also cause phthisis bulbi. One of them is retinoblastoma. This malignant tumor often occurs in children.

  • Injury to the eye

    Serious eye injury, such as open/closed globe injury, and injury to the eye from alkaline chemicals can cause damage to the eye leading to phthisis bulbi.

Diagnosis of phthisis bulbi

To diagnose phthisis bulbi, the ophthalmologist will conduct questions and answers regarding the complaints and symptoms experienced by the patient, history of eye injury, medical procedures that have been performed on the eye, and other medical history related to the eye.

After that, the doctor will perform a physical examination to assess the patient's visual ability, as well as an ophthalmoscopy examination, slit lamp, and examination of eye pressure with tonometry.

To confirm the diagnosis of phthisis bulbi, the doctor may also suggest supporting examinations, such as:

  • CT scan or MRI of the eye, to see tumors and damage to the eye
  • Biopsy of the eye, to see changes and growth of cells and tissues in the eye

Treatment of phthisis bulbi

Treatment of phthisis bulbi is not to cure or restore vision, but to relieve symptoms, prevent complications, and improve the appearance of the eye that has been damaged. Some of the treatments that can be done are:

Administration of drugs

Giving drugs is intended to treat the disease that causes it, for example antibiotics to treat bacterial infections of the eye. Medications are also given to treat symptoms, such as painkillers to relieve pain.


Surgery is required if the damage to the eye is extensive and severe. The types of surgery that can be done are enucleation (removal of the eyeball) and the installation of a prosthetic (artificial eye) to improve the appearance of the eye.

Complications of phthisis bulbi

Complications of phthisis bulbi are visual disturbances or permanent blindness.

Because this condition can be caused by various diseases of the eye, the complications that can occur can also vary, depending on the underlying disease.

Prevention of phthisis bulbi

The best way to prevent phthisis bulbi is to treat it as early as possible when eye problems occur. If there has been damage to the eye due to chronic disease of this organ, ask an ophthalmologist about the treatment that needs to be done to prevent the occurrence of phthisis bulbi.