Dr.PRIYADARSHINI KAMALAKANNAN

, Dr.PRAFULLA KUMAR MAHARANA, DR. NAMRATA SHARMA

Abstract

A 45 years old female presented with pain and redness for 1 month in the right eye with presenting BCDVA 6/36. On examination, a circular area of scleral thinning with ciliary staphyloma was noted in the superotemporal area in the scleral of the right eye. She was diagnosed to have necrotizing scleritis in the right eye. Her anti-CCP levels were also found to be elevated on systemic workup. A scleral patch graft was planned under general anesthesia. The area of scleral thinning was measured to be 7.5mm using Castrovejo calipers. The circular scleral thinning was managed with a scleral patch graft of 7.5mm cut using disposable trephines patched over the defect after performing a localized peritomy and sutured with 10-0 nylon sutures following which the peritomy was closed. A sequential scleral patch graft of 3mm was required in the same patient 2 months later. Necrotizing scleritis can thus be managed with repeated scleral patch grafts if required till a systemic cause is identified.