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Limbal Subconjunctival Abscess: A Rare Complication of Acanthamoeba Keratitis.

Cornea

September 2024

Department of Corneal and External Eye Diseases, Moorfields Eye Hospital, London, United Kingdom.

Purpose: Acanthamoeba keratitis (AK) is a rare infection affecting the cornea. Immune-mediated sclerokeratitis is a well-documented late complication often requiring systemic immunosuppression. We present an alternative clinical presentation of subconjunctival abscesses caused by direct invasion of the Acanthamoeba and a proposed management strategy.

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Article Synopsis
  • Efforts such as tenoplasty and amniotic membrane transplant failed to control the exposure, leading to the decision to use an oral (buccal) mucosal graft as a solution.
  • The oral mucosal graft successfully healed the previously exposed area, demonstrating its effectiveness for ocular reconstructions and suggesting it can be a useful alternative for similar conditions.
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Case of isolated scleromalacia perforans with seropositivity for rheumatoid arthritis.

BMJ Case Rep

June 2024

Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Scleromalacia perforans, or necrotising anterior scleritis, is a rare and severe form of eye disease that usually occurs in patients suffering from long-standing systemic inflammatory diseases, with rheumatoid arthritis (RA) being the most common. Here, we report the case of a patient who presented with redness of the eye and discolouration of the sclera and was diagnosed with scleromalacia perforans without any further extraophthalmic systemic involvement. Serological workup revealed highly positive cyclic citrullinated peptide (CCP) antibody (CCP-IgG/anticitrullinated protein antibodies) and positive rheumatoid factor, serologies commonly associated with RA.

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To review the latest surgical advances and evolving clinical use of scleral bio-tissue for reinforcement in the eye and review the published literature on novel surgical applications of scleral allograft bio-tissue. Conventional surgical procedures for scleral reinforcement using homologous scleral allograft have been traditionally ab-externo interventions comprising of anterior or posterior reinforcement of the sclera for clinical indications such as trauma, scleromalacia, glaucoma drainage device coverage, scleral perforation, buckle repair as well as posterior reinforcement for pathologic myopia and staphyloma. There have been a few novel ab-interno uses of scleral bio-tissue for reinforcement in both retina and glaucoma.

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