Management and outcome of microbial anterior scleritis.

Cornea

Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.

Published: September 2011

Purpose: To evaluate the prevalence, predisposing factors, and outcomes of bacterial and fungal scleritis.

Methods: We reviewed the clinical findings, therapeutic interventions, and visual outcomes of patients with suppurative scleral inflammation without preceding microbial keratitis who had microorganisms isolated from scleral scrapings.

Design: Retrospective interventional case series.

Results: Of 349 patients with scleritis diagnosed from 1999 to 2009, 6 adults (1.7%) presented with suppurative inflammation of the anterior sclera due to Pseudomonas aeruginosa (2), Streptococcus pneumoniae (2), Staphylococcus aureus (1), and Scedosporium apiospermum/Pseudallescheria boydii (1). Each had ocular surgery of the affected eye before presentation. Intraocular extension occurred in 2 eyes. After local and systemic antimicrobial therapy, all improved without evisceration or enucleation, and 4 attained vision of 20/60 or better.

Conclusions: Bacterial or fungal scleritis is an uncommon ocular infection that can belatedly follow anterior segment procedures. Antimicrobial therapy and surgical intervention can successfully control progressive suppuration and reduce vision-limiting complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154501PMC
http://dx.doi.org/10.1097/ICO.0b013e31820967bdDOI Listing

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