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Br J Ophthalmol 82:29-34 doi:10.1136/bjo.82.1.29
  • Original Article
    • Clinical science

Intrascleral dissemination of infectious scleritis following pterygium excision

Table 1

Infectious scleritis with multiple scleral abscesses

Case/ age (y)/ sex/eye Adjuncts to pterygium excision Latency period Organisms Cinical features Treatment Final VA
 Complication(s)
Medical
 Surgical
1/68/F/R NA 11 y 1 Enterobacterium cloacae; Pseudomonas aeruginosa Scleral abscesses; calcific plaque; ant uveitis; corneal infiltrate Topical and systemic cefazolin sodium and amikacin Debridement; enucleation — None
2 P aeruginosa
2/72/M/R NA 3 m 1 P aeruginosa Scleral abscesses; ant uveitis; corneal infiltrate; limited EOM Topical cefazolin sodium and amikacin Enucleation — None
2 P aeruginosa
3/73/F/R NA 10 y 1Aspergillus One scleral abscess in the first episode; calcific plaque; ant uveitis Topical cefazolin sodium and gentamicin, then amphotericin B§ Debridement; enucleation — Recurrence
4/40/F/R NA 8 y 1 P aeruginosa Scleral abscesses; calcific plaque; ant uveitis; limited EOM Topical cefazolin sodium and gentamicin and systemic gentamicin None 20/30 None
2 No growth
5/71/F/R Mitomycin C soaking 21 d 1 P aeruginosa; Lactobacillus; N subflava; Stomatococcus Scleral abscesses; calcific plaque Topical cefazolin sodium and gentamicin and systemic gentamicin Cryotherapy 20/200 Recurrence; complicated cataract
2 P aeruginosa
6/63/F/R NA 12 y 1 P aeruginosa One scleral abscess in the first episode; ant uveitis; limited EOM Topical and sytemic gentamicin Conjunctival flap 20/200 Recurrence; complicated cataract; inferior retinal detachment
2 No growth
7/65/M/R None 8 y 1 Bacillus; Staphylococcus epidermidis; Escherichia cloacae Scleral abscesses; ant uveitis Topical and systemic gentamicin None 20/200 Total retinal detachment; complicated cataract
8/74/M/R NA 32 y 1 P aeruginosa Scleral abscesses; calcific plaque Topical and systemic gentamicin Conjunctival flap 20/400 Inferior retinal detachment; complicated cataract
2 P aeruginosa
9/78/F/R Topical thiotepa 7 d 1 P aeruginosa Scleral abscesses; ant uveitis Topical cefazolin sodium and amikacin; systemic ticarcillin and amikacin Debridement 20/50 None
2 No growth
3 P aeruginosa
10/61/F/L NA 1 m 1 S epidermis; P aeruginosa Scleral abscesses; ant uveitis Topical and systemic cefazolin sodium and gentamicin Debridement HM None
2 P aeruginosa
11/61/M/L Mitomycin C soaking 21 d 1 P aeruginosa Scleral abscesses Topical cefazolin sodium and gentamicin systemic gentamicin and amikacin Cryotherapy; conjunctival flap 20/50 None
2 P aeruginosa
12/79/F/R NA 32 y 1 P aeruginosa Scleral abscesses; calcific plaque Topical cefazolin sodium and gentamicin; systemic gentamicin Conjunctival flap CF Inferior retinal detachment
13/62/F/L Topical mitomycin C 3.5 y 1 P aeruginosa Scleral abscesses; calcific plaque; ant uveitis; corneal infiltrate and perforation Topical cefazolin sodium and gentamicin; systemic gentamicin Glue; conjunctival flap; enucleation — Choroidal and total retinal detachment; complicated cataract
2 P aeruginosa
3 P aeruginosa
14/70/M/R NA 1.5 y 1 P aeruginosa Scleral abscesses; calcific plaque; ant uveitis Topical cefazolin sodium and amikacin; systemic amikacin Debridement LP Choroidal detachment
2 P aeruginosa
15/63/F/R NA 3 y 1 M fortuitum Scleral abscesses Topical cefazolin sodium and amikacin; systemic amikacin None 20/100 Recurrence
2 No growth
3 No growth
16/72/F/R None 3 y 1 P aeruginosa Scleral abscesses; calcific plaque; ant uveitis Topical cefazolin sodium and amikacin; systemic amikacin None 20/200 Choroidal detachment
2 P aeruginosa
17/76/F/L NA 25 y 1 P aeruginosa Scleral abscesses; calcific plaque; ant uveitis Topical cefazolin sodium and amikacin; systemic amikacin Debridement; conjunctival flap 20/200 Choroidal detachment
2 P aeruginosa
18/68/F/L NA 10 y 1 P aeruginosa Scleral abscesses; ant uveitis Topical cefazolin sodium and gentamicin; systemic gentamicin Conjunctival flap 20/100 Choroidal and retinal detachments
2 P aeruginosa
3 P aeruginosa

  • ↵Modifed from Moriarty et al.11

  • ↵1 = Result of first culture from initial scleral ulcer; 2, 3 = second and third culture result of subsequent abscesses.

  • ↵VA after extracapsular cataract extraction and intraocular lens implantation; § after the return of the culture reports.

  • NA=not available; y=year; m=month; d=day; ant=anterior; EOM=extraocular movements; VA=visual acuity; HM=hand movement; CF=counting fingers.

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