Causes of infectious scleritis

Fungus and microbial infection are the most common causes of infectious scleritis, according to study conclusions published in the February issue of Eye.

Vandana Jain, of the Aditya Jyot Eye Hospital, Mumbai, India, and colleagues conducted a retrospective chart review of all patients admitted to an Indian hospital with infectious scleritis between January 2000 and February 2005 (n=21) and then assessed factors including patient age, disease pathogenesis, clinical presentation, treatment and outcome.

The most common factors predisposing the patients to scleritis were previous surgery for cataract (n=6) or pterygium (n=5). In eight eyes, the scleritis was caused by fungus (most usually nocardia [n=5] or P. aeruginosa [n=2]), either as an isolated factor (n=5) or as a mixed infection (n=3). Scleritis was accompanied by corneal infiltration in seven eyes; multifocal scleral abscess and endophthalmitis each occurred in three eyes. To treat the condition, 14 eyes underwent surgical debridement and four eyes were eviscerated. During treatment, five eyes suffered either serous retinal or choroidal detachment, and five had progression of cataract. Visual acuity ≥20/200 was preserved in seven eyes.

Although the disease pathogenesis was similar in all cases, and the outcomes poor, the researchers concluded that fungi were the most common cause of infectious scleritis.