International Journal of Ophthalmology & Visual Science
Volume 5, Issue 2, June 2020, Pages: 61-65
Received: Apr. 5, 2020;
Accepted: Apr. 29, 2020;
Published: May 27, 2020
Views 215 Downloads 54
Anjana Somanath email@example.com, Department of Uvea, Aravind Eye Care System, Madurai, India
Raksheeth Rajgopal Nathan , Department of Uvea, Aravind Eye Care System, Madurai, India
Lalitha Prajna , Department of Microbiology, Aravind Eye Care System, Madurai, India
Rathinam Sivakumar , Department of Uvea, Aravind Eye Care System, Madurai, India
Infectious scleritis due to an infective etiology can occur following accidental trauma or surgery. However, the clinical manifestations of infectious scleritis may be similar to immune mediated scleritis. Infectious scleritis is treated with antibiotic therapy and surgical intervention if required. Treatment with corticosteroids and immunosuppressives may clinically worsen the infectious scleritis. Hence a careful clinical evaluation is necessary to rule out infectious etiology before treatment. Poor prognosis is due to delay in diagnosis and treatment. This study aimed to analyse the risk factors, clinical outcome and treatment in patients with infectious scleritis. A retrospective study was done from January 2013 to December 2018. This study includes 11 eyes. Microbiology analysis was done on the drained material. 11 eyes were culture positive. They were treated according to culture sensitivity. One eye worsened clinically and required enucleation. However, the other eyes improved and visual acuity was maintained in the 10 eyes. In our study, trauma was the most common cause of infectious scleritis. The common organisms were Nocardia, coagulase negative Staphylococcus aureus and fungi. To conclude, trauma was the most common cause of infectious scleritis in our study. Therefore, early diagnosis and treatment can lead to a reduced rate of complication.
Anjana Somanath firstname.lastname@example.org,
Raksheeth Rajgopal Nathan ,
Lalitha Prajna ,
Rathinam Sivakumar ,
Infectious Scleritis: Clinicomicrobiological Review of Infectious Scleritis, International Journal of Ophthalmology & Visual Science.
Vol. 5, No. 2,
2020, pp. 61-65.
Jabs DA, Mudun A, Dunn JP, Marsh MJ. Episcleritis and scleritis: clinical features and treatment results. Am J Ophthalmol. 2000; 130: 469–476.
Sainz de la Maza M, Jabbur NS, Foster CS. Severity of scleritis and episcleritis. Ophthalmology. 1994; 101: 389–396.
Tuft SJ, Watson PG. Progression of scleral disease. Ophthalmology. 1991; 98: 467–471.
Pradhan ZS, Jacob P. Infectious scleritis: clinical spectrum and management outcomes in India. Indian J Ophthalmol. 2013; 61: 590–593.
Reynolds MG, Alfonso E. Treatment of infectious scleritis and keratoscleritis. Am J Ophthalmol. 1991; 112: 543–547.
Loureiro M, Rothwell R, Fonseca S. Nodular Scleritis Associated with Herpes Zoster Virus: An Infectious and Immune-Mediated Process. Case Rep Ophthalmol Med. 2016; 2016: 8519394.
Reddy JC, Murthy SI, Reddy AK, Garg P. Risk factors and clinical outcomes of bacterial and fungal scleritis at a tertiary eye care hospital. Middle East Afr J Ophthalmol. 2015; 22: 203–211.
Hodson KL, Galor A, Karp CL, et al. Epidemiology and visual outcomes in patients with infectious scleritis. Cornea. 2013; 32: 466–472.
Hsiao CH, Chen JJ, Huang SC, Ma HK, Chen PY, Tsai RJ. Intrascleral dissemination of infectious scleritis following pterygium excision. Br J Ophthalmol. 1998; 82: 29–34.
Huang FC, Huang SP, Tseng SH. Management of infectious scleritis after pterygium excision. Cornea. 2000; 19: 34–39.
Sainz de la Maza M, Hemady RK, Foster CS. Infectious scleritis: report of four cases. Doc Ophthalmol. 1993; 83: 33–41.
Jain V, Garg P, Sharma S. Microbial scleritis-experience from a developing country. Eye (Lond). 2009; 23: 255–261.
Kumar Sahu S, Das S, Sharma S, Sahu K. Clinico-microbiological profile and treatment outcome of infectious scleritis: experience from a tertiary eye care center of India. Int J Inflam. 2012; 2012: 753560.
Cunningham MA, Alexander JK, Matoba AY, Jones DB, Wilhemus KR. Management and outcome of microbial anterior scleritis. Cornea. 2011; 30: 1020–1023.
Cunha LP da, Juncal V, Carvalhaes CG, Leão SC, Chimara E, Freitas D. Nocardialscleritis: A case report and a suggested algorithm for disease management based on a literature review. Am J Ophthalmol Case Rep. 2018; 10: 1–5.
Folk JC, Cutkomp J, Koontz FP. Bacterial scleral abscesses after retinal buckling operations. Pathogenesis, management, and laboratory investigations. Ophthalmology. 1987; 94: 1148–1154.
Chao DL, Albini TA, McKeown CA, Cavuoto KM. Infectious Pseudomonas scleritis after strabismus surgery. J AAPOS. 2013; 17: 423–425.
Kearney FM, Blaikie AJ, Gole GA. Anterior necrotizing scleritis after strabismus surgery ina child. J AAPOS. 2007; 11: 197–198.
Okhravi N, Odufuwa B, McCluskey P, Lightman S. Scleritis. SurvOphthalmol. 2005; 50: 351–363.
Chaidaroon W, Supalaset S. Pseudomonas Scleritis following Pterygium Excision. Case Rep Ophthalmol. 2017; 8: 401–405.
Alsagoff Z, Tan DT, Chee SP. Necrotisingscleritis after bare sclera excision of pterygium. Br J Ophthalmol. 2000; 84: 1050–1052.
Ma DH, See LC, Liau SB, Tsai RJ. Amniotic membrane graft for primary pterygium: comparison with conjunctivalautograft and topical mitomycin C treatment. Br J Ophthalmol. 2000; 84: 973–978.
Lin CP, Shih MH, Tsai MC. Clinical experiences of infectious scleral ulceration: a complication of pterygium operation. Br J Ophthalmol. 1997; 81: 980–983.
O’Donoghue E, Lightman S, Tuft S, Watson P. Surgically induced necrotisingsclerokeratitis (SINS)--precipitating factors and response to treatment. Br J Ophthalmol. 1992; 76: 17–21.
Foster CS, Maza MS de la. Infectious scleritis: the Massachusetts Eye and Ear Informary experiences. In: Foster CS, Maza MS de la. The sclera. New York: Springer Science & Business Media; 1994. p. 242-247.
Feiz V, Redline DE. Infectious scleritis after pars planavitrectomy because of methicillin-resistant Staphylococcus aureus resistant to fourth-generation fluoroquinolones. Cornea. 2007; 26: 238–240.