%0 Journal Article
%T Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India
%A Srikant Kumar Sahu
%A Sujata Das
%A Savitri Sharma
%A Kalyani Sahu
%J International Journal of Inflammation
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/753560
%X Medical and microbiology records of seventeen patients (17 eyes), diagnosed as scleritis of infectious origin were reviewed; to study clinical features, predisposing risk factors, microbiologic profile and treatment outcome of infectious scleritis. The mean patient age was years. Twelve patients (70.6%) had history of trauma/prior surgery. Isolated organisms included Staphylococcus species (spp) , Fungus , Nocardia spp , two each of atypical Mycobacterium spp and Streptococcus pneumoniae and one Pseudomonas aeruginosa. Treatment included intensive topical antimicrobial in all eyes and systemic medication in 15ˋ(88.2%) patients; surgical exploration was needed for 13ˋ(76.5%) patients and scleral patch graft was done in four (23.5%) patients. Lesions resolved in all patients and none required evisceration. The presenting log MAR visual acuity of and improved to . after treatment with a mean follow up of weeks. A microbiological confirmation, appropriate medical and/or surgical intervention has a good tectonic and visual outcome. 1. Introduction Infectious scleritis presents as an ulcerated or nonulcerated, inflamed scleral nodule [1]. It accounts for 5每10% of all cases of scleritis [2每5]. But the presenting picture of infectious scleritis may not differ too much from immune-mediated scleritis [6每10]. Approximately 40每90% of immune mediated scleritis have an associated systemic vascular disease [3, 4, 6, 10]. While systemic treatment with corticosteroids or immunosuppressant benefits immune-mediated scleritis, it worsens the infectious scleritis. Hence it is imperative to differentiate between two conditions. Many authors have reported infection by Pseudomonas aeruginosa and fungus as the most common causative organism [1, 11每13]. Pterygium surgery with beta radiation or application of mitomycin C has been identified as a common risk factor for infectious scleritis [11每13]. The clinical outcome is generally poor and most cases required evisceration in the many series [8, 9, 14]. Systemic and topical medication combined with early surgical intervention have improved the anatomical success, but not the visual outcome in two other series [1, 12]. Infectious scleritis is a rare entity; hence it is not suspected at the initial presentation resulting in delayed diagnosis and treatment. In this communication, we describe the predisposing factors, clinical features, etiology, and treatment outcome of infectious scleritis. 2. Material and Method We retrospectively reviewed the medical and microbiological records of all patients with microbiologically proven
%U http://www.hindawi.com/journals/iji/2012/753560/