PURPOSE: To assess the proper differential diagnosis and treatment of scleritis with scleral melt following pterygium excision. METHODS: A retrospective study through a review of medical records of 5 patients diagnosed with surgically induced necrotizing scleritis (SINS) after pterygium excision and treated with systemic immunosuppressant and steroid. RESULTS: All the patients responded to the treatment and showed significant improvement. CONCLUSIONS: Immunosuppressive treatment without surgical intervention is effective in resolution of SINS after pterygium excision.
Diagnosis, Differential ; Humans ; Medical Records ; Pterygium* ; Retrospective Studies ; Scleritis*

Posterior scleritis must be one of the most underdiagnosed treatable conditions in ophthalmology, partly because its manifestations are so protean and partly because the diagnosis is rarely considered. Although ultrasonography and computer tomogram are ancilliary tests, a careful examination of the posterior segment of the eye including the area of the ora serrata, macula and disc is essential to discover the presence of a posterior scleritis. We experienced prolonged retinal pigment epithelial detachments which had appered at early phase of posterior scleritis.
Bruch Membrane ; Diagnosis ; Ophthalmology ; Retinal Detachment* ; Retinaldehyde* ; Scleritis* ; Ultrasonography

No abstract available.
Adult ; Female ; Humans ; Recurrence ; Retina/*pathology ; Scleritis/*complications/diagnosis ; Tomography, Optical Coherence ; Uveomeningoencephalitic Syndrome/complications/*diagnosis

The ocular manifestations of rheumatoid arthritis (RA) are common and they can vary from patient to patient. However, necrotizing anterior scleritis without inflammation (scleromalacia perforans) is a rare and serious opthalmic complication, and it is typically associated with long-standing RA. Although the etiology and pathogenesis of scleromalacia perforans are diverse and they are not completely understood, ophthalmic surgery is one of the well known causes of scleromalacia perforans. Patients with systemic autoimmune disease such as RA have an especially higher risk of scleromalacia perforans after opthalmic surgery. Because scleromalacia perforans is a potential threat not just to eyesight, but to life as well, early diagnosis and prompt treatment are required for its successful management. We experienced a case of scleromalacia perforans that developed after scleral excision of pterygium in a 58 year old woman who had a 7 year history of RA, and this was well treated with an early screral graft. We report here on this case along with a review of the relevant literature.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Early Diagnosis ; Female ; Humans ; Inflammation ; Polyenes ; Pterygium ; Scleritis ; Transplants

Necrotizing scleritis is an uncommon but most severe form in scleritis both in terms of pain and scleral destruction. It occasionally associated with systemic connective tissue diseases or idiopathic in orgin. Adequate diagnosis and therapy are essential to every ophthalmologist because it takes disastrous clinical course frequently. Histopathologically, localized granulomatous vasculitis was found and in pathogenesis, immunologic mechanism is suggested. We treated two cases of necrotizing scleritis which developed after pars plana vitrectomy, with topical or systemic corticosteroids and in one case, whose sclera was extensively melted, grafting with fascia lata was made with sucessful result. Two eyes became quiet after months of treatment without sequelae by scleritis itself We thought that this conditions occured by electrical low current diathermy which was given for hemostasis around sclerotomy incisions and by diabetic microcirculatory disturbances although not proven histologically.
Adrenal Cortex Hormones ; Connective Tissue Diseases ; Diagnosis ; Diathermy ; Fascia Lata ; Hemostasis ; Sclera ; Scleritis* ; Transplants ; Vasculitis ; Vitrectomy*

PURPOSE: We report a case of orbital pseudotumor developed in an anophthalmic socket, presenting no typical symptoms or signs. METHODS: A 67-year-old woman was referred for treatment of necrotizing scleritis of her left eye and painful orbital pseudotumor of her right eye. The right eye had been removed 10 years previously. There was an irregular mass in superomedial portion of anterior orbit. Orbital MRI showed poorly defined T1 iso and low T2 signal intensity of a lesion in the medial anterior portion of the right orbit. Because systemic steroid administration was limited, 2 mg of betamethasone was injected locally, after which the size of the lesion was decreased and the orbital pain improved. CONCLUSIONS: The diagnosis of an orbital pseudotumor developed in an anophthalmic socket may be difficult because of the lack of typical eyeball-related signs or symptoms such as proptosis, red eye, or decreased vision. But, the easy access to the lesion can provide early and effective treatment through direct injection of glucocorticoid.
Aged ; Anophthalmos* ; Betamethasone ; Diagnosis ; Exophthalmos ; Female ; Humans ; Inflammation* ; Magnetic Resonance Imaging ; Orbit* ; Orbital Pseudotumor ; Scleritis

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.
Corneal Ulcer ; Diagnosis ; Eye Diseases* ; Iritis ; Joints ; Pericardium ; Pleura ; Prognosis ; Rheumatic Diseases* ; Scleritis ; Sjogren's Syndrome

Posterior scleritis is an uncommon disease. Its clinical manifestations may include pain. reduced visual acuity, cellular infiltration in the aqueous and vitreous humor, serous retinal detachment, chorioretinal lesions, and disc or macular edema. The diagnosis of posterior scleritis is often difficult due to its rarity and the diversity of symptoms. However, ultrasography and computed tomography are noninvasive methods for diagnosis of posterior scleritis. We treated posterior scleritis associated with ciliochoroidal detachment and anterior uveitis with sclerotomy, drainage of ciliochoroidal fluid in a background diabetic retinopathy patient.
Ants* ; Diabetic Retinopathy* ; Diagnosis ; Drainage ; Humans ; Macular Edema ; Retinal Detachment ; Scleritis* ; Uveitis* ; Uveitis, Anterior ; Visual Acuity ; Vitreous Body

Approximately 50 % of patients with scleritis are known to be associated with systemic connective tissue diseases or vasculitic diseases such as rheumatoid arthritis (RA), Wegener's granulomatosis, relapsing polychondritis, and systemic lupus erythematosus. The patients with scleritis in association with Behcet's disease (BD) have been rarely described in the literature. We report a 46-year-old female patient with BD who developed the nodular scleritis.
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Behcet's Syndrome/drug therapy ; Behcet's Syndrome/diagnosis* ; Behcet's Syndrome/complications* ; Case Report ; Cyclophosphamide/therapeutic use ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Human ; Middle Age ; Prednisolone/therapeutic use ; Scleritis/drug therapy ; Scleritis/diagnosis* ; Scleritis/complications*

A 52 year-old, contact lens-wearing man presented with progressive right eye pain and redness for one month. He had been evaluated and treated for necrotizing scleritis by multiple eye care specialists prior to presentation. He underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis, including a culture. The culture revealed heavy growth of Nocardia asteroides complexes. The patient was treated with topical amikacin and oral Bactrim. Following several weeks of antibiotic treatment, the patient's infection resolved completely, and his visual acuity returned to baseline status. Nocardia is a rare but potentially devastating cause of necrotizing scleritis that may affect contact lens wearers without an associated keratitis. Prompt recognition and early treatment with appropriate antimicrobial agents are critical to achieve a favorable outcome.
Anti-Bacterial Agents/therapeutic use ; Contact Lenses/*adverse effects/*microbiology ; Humans ; Male ; Middle Aged ; Nocardia Infections/*diagnosis/drug therapy ; Nocardia asteroides/*isolation & purification ; Scleritis/drug therapy/*microbiology