J Korean Ophthalmol Soc.  2017 Jun;58(6):736-739. 10.3341/jkos.2017.58.6.736.

A Case of Recurrent Scleritis Associated with Menstrual Cycle

• Kim AY
• Han KE
• Jun RM

• KMID: 2382685
• DOI: http://doi.org/10.3341/jkos.2017.58.6.736

Abstract

PURPOSE
To describe a case of recurrent scleritis associated with a patient's menstrual cycle.
CASE SUMMARY
A 27-year-old woman presented to our ophthalmology department with redness and pain in her left eye over 2 days. She received laser-assisted in situ keratomileusis surgery for both eyes 6 years prior and was diagnosed with scleritis in her left eye 3 years prior. She was referred to rheumatologic department to determine if she had auto-immune disease, but the systemic review was negative. She was diagnosed with idiopathic scleritis and was treated with oral Methylprednisolone to provide symptom relief. However, her symptoms exhibited a recurrent pattern. These symptoms regularly affected her during the 2-3 days before menstruation, which had been occurring for more than 10 years, beginning when she was a middle school student. The symptoms affected both eyes and did not improve when treated with topical non-steroid anti-inflammaroty drugs (NSAIDs), topical steroids, or oral NSAIDs. However, her symptoms were relieved when treated with oral steroids. Beginning with her pregnancy and extending through her delivery and breast-feeding periods, follow up had been interrupted, but she noted that recurrence episodes were rare during this time. To this day, her symptoms appear once per month and are controlled through oral steroids.
CONCLUSIONS
Literature reviews have revealed no such case reports regarding recurrent scleritis associated with the female menstrual cycle. If cyclic recurrence of scleritis episodes is present in a female patient, a careful history should be taken in order to evaluate any possible associations with the menstrual cycle.

Keyword

Hormonal; Menstruation; Recurrent; Scleritis

MeSH Terms

Adult
Anti-Inflammatory Agents, Non-Steroidal
Female
Follow-Up Studies
Humans
Menstrual Cycle*
Menstruation
Methylprednisolone
Ophthalmology
Pregnancy
Recurrence
Scleritis*
Steroids
Anti-Inflammatory Agents, Non-Steroidal
Methylprednisolone
Steroids

Figure

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  Figure 1 Anterior segment photographs during the perimenstrual perids. (A) The swollen sclera and engorged scleral vessels were seen on the temporal side of the right eye. (B) Conjunctival injection on the temporal side of the left eye was observed.

• 

  Figure 2 After taking oral methylprednisolone 24 mg per day for two weeks. (A) Scleral elevation and vessel engorgement were resolved. (B) Conjuntvial injection was not observed.

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