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Scleromalacia

Presentation

Clinical Presentation Patients with scleromalacia perforans present with deep scleral ulcerations. These scleral ulcerations coalesce, and the thinned sclera shows a bluish color from the underlying uveal tissue. [link.springer.com]

She presented to us with pronounced eye manifestation which on further inquiry and investigation was found to be associated with rheumatoid arthritis. There was perforation of left globe on presentation and the right one was preserved. [springermedizin.de]

A patient is described who presented with a scleral defect which appeared dangerously close to perforation. Surgical management of this patient with an autologous scleral graft is discussed. [ncbi.nlm.nih.gov]

Rheumatoid arthritis (RA) should be high on the differential diagnosis of patients who present with scleromalacia. Autoimmune damage to the lacrimal gland can result in severe dry eye in patients with RA. [webeye.ophth.uiowa.edu]

Entire Body System

  • Weight Gain

    Different side effects of steroids that should be taken care include elevated intraocular pressure, decreased resistance to infection, gastric irritation, osteoporosis, weight gain, hyperglycemia, and mood changes. [eyewiki.aao.org]

Workup

A systemic workup revealed Wegener's granulomatosis as the cause of this patient's necrotizing scleritis. [webeye.ophth.uiowa.edu]

Diagnosis, Workup and Treatment Further investigation into the patient’s ocular history found that he had undergone the I-Brite eye-whitening procedure four years prior to presentation. [reviewofophthalmology.com]

Laboratory test As scleritis may occur in association with many systemic diseases, laboratory workup may be extensive. [eyewiki.aao.org]

Treatment

Even so, certain treatments may slow or stop the progression of the disease. Treatments and procedures commonly used include the following. [verywellhealth.com]

Perforans from Long-Standing Bulbar Conjunctival Rhinosporidiosis. ( 27342330 ) Bothra N...Tripathy D 2016 4 Bilateral scleromalacia perforans and peripheral corneal thinning in Wegener's granulomatosis. ( 22553696 ) Reddy SC...Rohana T 2011 5 Infliximab treatment [malacards.org]

Rituximab is a widely used biologic agent, which has shown favourable results in the treatment of vasculitis. But immunosuppressive treatment also bears the risk of severe complications. [ncbi.nlm.nih.gov]

Surgery Surgical treatment of SP is necessary in cases with exposed uvea to preserve the globe integrity. [eyewiki.aao.org]

Prognosis

Prognosis As with the treatment of scleromalacia perforans, the prognosis of the disease can vary enormously, informed by everything from a person's age and general health to the multitude of risk factors that influence astigmatism, cataracts, glaucoma [verywellhealth.com]

Treatment and prognosis The condition is usually asymptomatic. Rupture of the globe is rare and usually only seen in those with coexisting markedly elevated intraocular pressure, i.e. severe glaucoma 1. [radiopaedia.org]

Prognosis Gradual reduction of vision is mainly due to progressive astigmatism. References ↑ American Academy of Ophthalmology. [eyewiki.aao.org]

Etiology

The Rôle of Various Factors in the Etiology of Periarteritis Nodosa in Experimental Animals. Am J Pathol. 1947 Jan;23(1):147–157. [PMC free article] [PubMed] [Google Scholar] VAIL D. The ocular complications of arthritis. [ncbi.nlm.nih.gov]

EVOLUTION ETIOLOGIE OEIL PATHOLOGIE SYSTEME OSTEOARTICULAIRE PATHOLOGIE HOMME OPHTALMOLOGIE Keyword (en) SCLEROMALACIA PERFORMANS UNILATERAL HOMOGRAFT MUCOSA ORAL CAVITY SCLERA CATARACT EXTRACTION RHEUMATOID ARTHRITIS SURGERY EYE COMPLICATION EVOLUTION ETIOLOGY [pascal-francis.inist.fr]

Etiology Unknown Clinical Presentation Patients with scleromalacia perforans present with deep scleral ulcerations. These scleral ulcerations coalesce, and the thinned sclera shows a bluish color from the underlying uveal tissue. [link.springer.com]

Etiology It is a type III hypersensitivity reaction which occurs due to accumulation of immune complexes (Antigen-Antibody complexes). Risk Factors Scleromalacia perforans typically occurs in elderly women with long-standing rheumatoid arthritis. [eyewiki.aao.org]

Epidemiology

Aspects of epidemiology, pathogenesis and therapy. Dev Ophthalmol 1999; 30: 91–109. Article CAS Google Scholar Okhravi N, Odufuwa B, McCluskey P, Lightman S. Scleritis. Surv Ophthalmol 2005; 50 (4): 351–363. [nature.com]

Keywords Scleromalacia perforans; Rheumatoid nodules; Extraarticular arthritis; Immunosuppressive therapy Classification, Epidemiology, Clinical Manifestations The sclera is a dense connective tissue covering about five sixths of the eye [ 1, 2 ]. [omicsonline.org]

The autoimmune nature of scleritis also is supported by the frequent association with systemic autoimmune disorders and by the favorable response to immunosuppressive therapy. [2] Epidemiology Frequency United States Although scleritis is uncommon, the [emedicine.medscape.com]

There was an increase in total cholesterol and HDLc levels and no improvement of the atherogenic index. [127] Epidemiology [ edit ] Deaths from rheumatoid arthritis per million persons in 2012 0–0 1–1 2–3 4–5 6–6 7–8 9–9 10–12 13–20 21–55 RA affects between [en.wikipedia.org]

Keywords: Scleromalacia perforans; Rheumatoid nodules; Extraarticular arthritis; Immunosuppressive therapy Classification, Epidemiology, Clinical Manifestations The sclera is a dense connective tissue covering about five sixths of the eye [1,2]. [longdom.org]

Pathophysiology

Pathophysiology Young and Watson suggest three determinants of scleral destruction: activation of scleral fibrocytes and resorption of pericellular matrix, infiltration of the scleral stroma by inflammatory cells, prolonged local vaso-occlusion. [eyewiki.aao.org]

Prevention

Glaucoma implant surgery using autogenous fascia lata to form a healthy ground and a patch graft to prevent tube erosion seems to be a safe and effective method when normal sclera is lacking, such as in scleromalacia perforans. [ncbi.nlm.nih.gov]

Immunomodulators: Because scleromalacia perforans is largely driven by autoimmunity, immunomodulators can be used to tamp down the autoimmune response and prevent disease progression. [verywellhealth.com]

Treating underlying autoimmune conditions that might cause scleritis is also important in preventing future problems with the sclera. [healthline.com]

In the CF alone group, we prevented the progress of avascular scleral melting, but there was cosmetic problem due to filling defect. [iovs.arvojournals.org]

Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. [icdlist.com]

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