Acute Scleritis Research Articles

Bee sting injury masquerading as scleritis in a patient of mycosis fungoides

A 57-year-old male, diagnosed with mycosis fungoides and managed with immunomodulators, presented with a history of acute exacerbation of pain and redness in the right eye for 1 week. On examination, the patient exhibited a bright erythematous lesion involving the ala and apex of the nose. A provisional diagnosis of acute scleritis secondary to mycosis fungoides was made, and the patient was initiated on oral and topical steroids. Within 2 weeks, the patient gradually improved; however, with decreased congestion and increased visibility of the ocular surface, a pigmented foreign body was visualized in the subconjunctival space, which was subsequently removed with a 26-gauge needle. Surprisingly, histopathologic examination revealed the foreign body to be a bee sting.

Acute scleritis and nonerythrodermic skin rash: An unusual presentation of Sézary syndrome

Acute scleritis and nonerythrodermic skin rash: An unusual presentation of Sézary syndrome

Ocular hypertension and glaucoma incidence in patients with scleritis

Scleritis belongs to the group of chronic inflammatory eye diseases that may cause ocular hypertension (OHT) and secondary glaucoma (SG). Aim of this study was to identify the incidence and risk factors for OHT and SG with regard to the scleritis form. Single-center retrospective analysis of all consecutive patients with scleritis. A total of 271 scleritis patients (161 women, mean age 51.0 ± 16.9 years) were enrolled. The median follow-up was 17.0 ± 21.4 months (range 6-116). Of these patients, 56 (21 %) showed an intraocular pressure (IOP) increase with an open chamber angle at any time during follow-up. Another four patients (7 %) had secondary angle-closure glaucoma. An increase in IOP was found more frequently in patients with necrotizing (42 %) than in those with posterior (30 %), nodular (18 %) or diffuse anterior scleritis (18 %, p = 0.022). Most patients (82 %) developed the pressure increase during acute scleritis episodes. Initially, 72 % of patients with increased IOP were classified as OHT; this figure had decreased to 56 % at the end of follow-up. In the course of disease, the IOP normalized in 13 %. The univariate analysis of risk factors showed an increased risk in the presence of anterior uveitis, peripheral ulcerative keratitis, posterior synechiae, and previous cataract surgery. An increase in IOP occurs in about one-fifth of patients with scleritis. The initial pressure elevation occurs mostly in the acute phase of disease. An increase in pressure is found most often in patients with necrotizing scleritis.

Syphilis presenting as scleritis in an HIV‐positive man undergoing immune reconstitution

A 45-year-old HIV-positive man receiving highly active antiretroviral therapy (HAART) presented with 6 weeks of right-sided headache and right eye pain. He had been diagnosed seropositive 2 years previously and screened negative for syphilis at that time. Examination demonstrated focal anterior scleritis with underlying retinitis and a mild vitritis. He was found to have positive syphilis serology and further investigations were consistent with neurosyphilis. Parenteral penicillin was commenced with prompt clinical response. This initial presentation of syphilis as acute scleritis emphasizes the need for thorough work-up of immunocompromised patients with inflammatory ocular disease.

Acute Scleritis in Porphyria Cutanea Tarda

We examined three patients who had dermatologic and biochemical manifestations of porphyria cutanea tarda and localized thinning or excavation in the sun-exposed interpalpebral sclera, adjacent to the cornea. All three patients had signs of acute scleritis. The acute scleritis responded to oral indomethacin in one patient, but systemic corticosteroids were required to control the inflammation in the other two patients. Phlebotomy, protection from sunlight, and refraining from alcohol played an important part in the treatment of the patients.