Ophthalmologic Manifestations of Diphtheria Treatment & Management

Updated: Feb 18, 2019
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Medical Care

Treatment includes supportive care and isolation, as well as penicillin or erythromycin, which are extremely effective against C diphtheriae.

Diphtheria antitoxin, a hyperimmune antiserum produced in horses, protects against neurotoxicity when given within the first or second day of the illness. Prevention is accomplished by immunization with formalin-inactivated toxin, usually given within the first year of life. [3]

Additional treatment of primary ocular infection includes topical erythromycin ointment, frequent manual removal of infected membranes, and ocular lubrication. Topical steroids may be used to reduce inflammation if no corneal ulceration is present.

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Prevention

From 1991 through 1998, there was a massive epidemic of diphtheria in the Independent States of the Former Soviet Union, representing the first large-scale diphtheria outbreak in developed countries in more than 30 years. This occurred because of vaccine shortages and laxity in diphtheria immunization programs. Beginning in 1995, aggressive control strategies were implemented through mass vaccination with diphtheria toxoid, resulting in a major decrease in new cases of diphtheria by 2000.

The availability of vaccines in the United States is now threatened by systemic problems in the development, purchase, and distribution of vaccines. The number of companies that produce vaccines for the United States has declined markedly since the 1960s, and today, only 5 companies produce all routine vaccines for this market. There is only one supplier for measles, mumps, and rubella (MMR); diphtheria, pertussis, and tetanus (DPT); and polio; and if this supplier ceases production, it could take years to have a replacement vaccine licensed and publicly available. [4]

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Long-Term Monitoring

Patients should receive follow-up care until the conjunctivitis is resolved.

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