Immunologic and clinical manifestations of infectious scleritis after pterygium excision

Abstract

Purpose: To present the immunologic status and clinical manifestations of patients who had infectious scleritis after pterygium excision.

Methods: This prospective noncomparative study of immunologic status and clinical manifestations involved 18 eyes of 18 patients with infectious scleritis (16 bacterial and 2 fungal infections) with a history of pterygium excision from 1999 to 2001.

Results: The period between pterygium excision and scleritis ranged from 1 to 36 years. None of the 18 patients had any history of systemic autoimmune disease. Elevated erythrocyte sedimentation rates were found in 9 (50%) of 18 patients. Elevated serum C-reactive protein levels were found in 9 (75%) of 12 patients. Other serologic tests were all negative. The most common pathogen of infectious scleritis, Pseudomonas aeruginosa, was present in 13 patients (72.2%), significantly higher than any others (P < 0.05). All of the eyeballs were salvaged, and 9 (50%) of 18 patients had final vision better than 2/20.

Conclusion: There was no underlying autoimmune disease associated with infectious scleritis in this study. Early diagnosis and aggressive medical and surgical treatment might have saved the eyes.