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Letter
Bilateral surgically induced necrotising scleritis with secondary superinfection
  1. M R Vagefi1,
  2. D A Hollander1,
  3. G D Seitzman2,
  4. T P Margolis2
  1. 1Department of Ophthalmology, University of California, San Francisco, CA, USA
  2. 2Department of Ophthalmology and The Francis I Proctor Foundation, University of California, San Francisco, CA, USA
  1. Correspondence to: Todd P Margolis MD The Francis I Proctor Foundation, 95 Kirkham Street, Room 305, University of California at San Francisco, San Francisco, CA 94143–0944, USA; tpmsitsa.ucsf.edu

https://doi.org/10.1136/bjo.2004.051359

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    Surgically induced necrotising scleritis (SINS) is a rare complication of ocular surgery that has been described after pterygium excision, cataract extraction, trabeculectomy, penetrating keratoplasty, strabismus surgery, and retinal detachment repair.1–3 We describe a rare case of bilateral necrotising scleritis complicated by a secondary polymicrobial infection following uncomplicated phacoemulsification and pterygia excision.

    Case report

    A 66 year old Samoan male, with type II diabetes, end stage renal disease, coronary artery disease, and gout underwent uncomplicated combined phacoemulsification and bare sclera pterygium excision (without antimetabolites) in the right eye, followed 1 month later by the same combined procedure in the left eye. Three weeks later, the patient developed severe right sided eye pain. An erythrocyte sedimentation rate was 98 mm in the first hour, and oral prednisone (80 mg/day) was initiated. A temporal …

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