J Korean Rheum Assoc.  2010 Mar;17(1):93-97. 10.4078/jkra.2010.17.1.93.

A Case of Scleromalacia Perforance That Developing after Surgery for Excision of the Pterygium in a Patient with Rheumatoid Arthritis

• Kim JH
• Kim HO
• Jeong YG
• Yun SU
• Lee KJ
• Lee CM
• Kim WS
• Song JK
• Lee SI

• KMID: 2202000
• DOI: http://doi.org/10.4078/jkra.2010.17.1.93

Abstract

The ocular manifestations of rheumatoid arthritis (RA) are common and they can vary from patient to patient. However, necrotizing anterior scleritis without inflammation (scleromalacia perforans) is a rare and serious opthalmic complication, and it is typically associated with long-standing RA. Although the etiology and pathogenesis of scleromalacia perforans are diverse and they are not completely understood, ophthalmic surgery is one of the well known causes of scleromalacia perforans. Patients with systemic autoimmune disease such as RA have an especially higher risk of scleromalacia perforans after opthalmic surgery. Because scleromalacia perforans is a potential threat not just to eyesight, but to life as well, early diagnosis and prompt treatment are required for its successful management. We experienced a case of scleromalacia perforans that developed after scleral excision of pterygium in a 58 year old woman who had a 7 year history of RA, and this was well treated with an early screral graft. We report here on this case along with a review of the relevant literature.

Keyword

Rheumatoid arthritis; Scleromalacia perforans; Pterygium

MeSH Terms

Arthritis, Rheumatoid
Autoimmune Diseases
Early Diagnosis
Female
Humans
Inflammation
Polyenes
Pterygium
Scleritis
Transplants
Polyenes

Figure

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  Fig. 1. The left eye shows extreme thinning of the paranasal sclera without inflammation.

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  Fig. 2. The scleral thinning of the left eye recovered after a scleral graft.

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