Epidemiology and visual outcomes in patients with infectious scleritis

Abstract

Purpose: To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis.

Methods: Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis.

Results: Fifty-five patients (56 eyes) with confirmed infectious scleritis were included. The median time from inciting event to scleritis symptoms was 1.9 months. Eyes with a history of pterygium surgery had a longer time from surgery to development of scleritis (median 49 months, range 0-183) compared to those with a history of glaucoma, cataract, and retina surgery (median 1.0-1.6 months; P = 0.001). Fungal, nocardial, and mycobacterial infections (median 17-45 days) had a longer interval between symptoms and diagnosis than eyes with non-acid-fast gram-positive and gram-negative bacteria (median 7 days; P = 0.04). Patients were followed for a median of 11.1 months (0.5-47 months). Approximately 50% of eyes lost functional vision (worse than 20/200). Presenting VA of worse than 20/200 and concomitant keratitis or endophthalmitis were associated with poorer VA outcomes.

Conclusions: Infectious scleritis can occur days to years after ocular surgery, with infection occurring after a longer interval in eyes with a history of pterygium surgery. Approximately 50% of eyes lost functional VA after infection with poor presenting VA being the strongest predictor for subsequent severe vision loss.