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Case Reports
. 2020 Apr 3:10:Doc20.
doi: 10.3205/oc000147. eCollection 2020.

Necrotizing scleritis after strabismus surgery in Treacher Collins syndrome

Soveeta Rath  1 , Suma Ganesh  1 , Umang Mathur  2 , Manasvini Sharma  1
Affiliations
Case Reports

Necrotizing scleritis after strabismus surgery in Treacher Collins syndrome

Soveeta Rath et al. GMS Ophthalmol Cases. .

Abstract

Objective: To describe a case of surgically induced scleral necrosis in Treacher Collins syndrome after strabismus surgery. Methods: A 19-year-old girl underwent bilateral squint surgery. Two weeks postoperatively, she presented with subconjunctival abscess in the left eye. The surrounding conjunctiva was markedly inflamed with raised edges. Surgical debridement, microbiological evaluation and medical management were started immediately. Screening for autoimmune and vasculitic conditions did not provide any positive results. Results: On subsequent follow-up, conjunctival retraction and an area of scleral necrosis with thinning was noted. Significant healing with antibiotics and steroids was noted within one week. The integrity of the globe was well maintained and no further procedure for tectonic support was performed. Conclusion: Surgically induced scleral necrosis can be immune-mediated or following surgical site infection. Pre-existing scleral thinning due to neuroectodermal apoptosis in Treacher Collins syndrome remains a possible explanation for the accelerated necrotising scleritis in our case.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. The facial dysmorphic features of Treacher Collins syndrome
Figure 2
Figure 2. Ruptured subconjunctival abscess
Figure 3
Figure 3. Resolving subconjunctival abscess with scleral necrosis and necrosed medial rectus
Figure 4
Figure 4. Resolved inflammation with formation of staphyloma
See this image and copyright information in PMC

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