Infectious Scleritis

Scleritis is an inflammation of the sclera, the outer layer of the globe. Scleritis can concurrently involve the cornea, episclera, and uvea. Symptoms of scleritis can involve focal or diffuse hyperemia, pain, and visual impairment. Although the majority of scleritis cases are due to an autoimmune etiology, approximately 5 to 10% of cases are infectious.  The clinical symptoms for both infectious and autoimmune scleritis can appear similar. As a result, infectious cases may be managed as autoimmune, possibly worsening the outcome. To differentiate infectious from autoimmune scleritis, accurate history is crucial. About 94% of patients (n=48) had a predisposing factor for the infection. The most common factor was previous ocular surgery (83%), particularly pterygium excision (57%), which was the majority of cases. Other correlated factors included prior accidental eye injury, use of radiation, and the use of an antineoplastic like mitomycin. Several organisms have been identified as agents for infectious scleritis, with reported as the most common organism in developed countries.  Other known vectors include bacteria or fungal organisms such as andUntreated, infectious scleritis can result in the loss of the eye due to the spread of infection to surrounding structures or perforation of the globe.