Treatment of Scleritis in Infectious Scleritis
Infectious scleritis is a serious condition in which a pathogen invades the sclera. Once invasion occurs, eradication is extremely difficult, and management requires a targeted approach matched to the causative organism.
Clinical Scenario
Infectious scleritis can be viral, bacterial, fungal, or parasitic in origin. The avascular nature of necrotic scleral tissue severely limits antimicrobial penetration, making this a particularly challenging subtype to treat.
Treatment Approach
Management may involve a surgical component alongside antimicrobial therapy; the specific strategy — including the choice of agents and route — depends on the causative organism and is detailed in the full protocol.
Clinical Goal
Primary target: Eradication of the scleral infection.
References
DOI: 10.1016/j.survophthal.2005.04.001
- Infectious scleritis can be viral, bacterial, fungal, and parasitic.
- Pyogenic infections of the sclera are often difficult to manage and eradicate because of the poor antimicrobial penetration into the avascular necrotic sclera, but improved success has been achieved with surgical intervention in addition to antimicrobial therapy, or a combination of parenteral antimicrobials.
- A case report of Sporothrix schenckii scleritis following trauma with a wood chip failed to respond to topical miconazole and topical amphotericin as well as intravenous amphotericin but had a good response to saturated solution of potassium iodide 10–24 drops orally three times a day for 10 days.
- Once the sclera is invaded, the infection is extremely difficult to eradicate.
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