Presentation
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]
(Present on Admission - Yes) Total Medicare Hospitalizations - Jan 2013 to Dec 2017 (Present on Admission - Yes) Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) Total Medicare Hospitalizations - Jan 2013 to Dec 2017 [dexur.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]
Entire Body System
- Inflammation
Living reference work entry First Online: 10 June 2016 DOI: https://doi.org/ 10.1007/978-3-642-35951-4_727-1 Synonyms Definition An aggressive form of scleritis presenting with necrosis but no signs of inflammation. [link.springer.com]
Abstract Rheumatoid disease can cause ocular inflammation of the conjunctiva, sclera, and uveal tract. The sclera is an avascular layer covered by the episclera that is highly vascularised and can be affected by inflammation. [reumatismo.org]
Scleromalacia perforans is characterized by severe thinning of the sclera of the eye and can be categorized into two types, with inflammation and without inflammation. This type of scleritis is often associated with severe rheumatoid arthritis. [verywell.com]
FIGURE 2: (A) Conjunctiva surrounding scleral ulceration, resected at the time of dura-mater grafting, revealing severe chronic inflammation (original magnification ? 176). [healio.com]
- Pain
She said that she had severe pain in both eyes with gritty sensation, around 8/10 on Visual Analog of Pain Scale (VAPS); she associated this pain with dryness of eyes and she stated that there had also been pus discharge from her left eye and progressive [ncbi.nlm.nih.gov]
- Swelling
Signs and Symptoms redness chemosis (conjunctival swelling) eyelid swelling proptosis (eye bulging outward) decreased vision Additionally, doctors may see: choroidal folds retinal elevation optic disc swelling macular swelling retinal detachment Complications [verywell.com]
Uncommon: corneal erosion, keratitis, punctate keratitis, keratopathy, deposit eye, corneal staining, corneal epithelium defect, corneal epithelium disorder, blepharitis, eye pruritus, conjunctivitis, eye swelling, meibomianitis, glare, photophobiadry [tr-ex.me]
Pain from scleritis is also related to inflammation, so reducing the swelling will decrease symptoms. The treatment follows a stepladder approach. If the first step in medication fails, then the second is used. [healthline.com]
She had severe pain around 7/10 on VAPS associated with joint swelling. On examination she was vitally stable and anemic. The examination revealed acute synovitis in the joints of her hands and feet. [ncbi.nlm.nih.gov]
- Surgical Procedure
[…] reconstructive surgical procedures. [books.google.ro]
Purpose : To report a new surgical procedure using biodegradable collagen matrix (Ologen) implantation with conjunctival flap for reconstruction of scleromalacia after periocular surgery. [tandfonline.com]
procedures may present areas of scleral thinning or even choroidal exposure and bulging. [evrs.eu]
Therefore the authors decided to try the new biomaterial instead of autologous scleral tissue to avoid additional scleral or ocular surface damage from the surgical procedure itself. [bmcophthalmol.biomedcentral.com]
Eyes
- Scleral Disease
This case indicates that senile scleromalacia is a scleral disease sui generis which occurs by expulsion of a calcified plaque in advanced cases of senile scleral plaques. Senile scleromalacia has not previously been described as a clinical entity. [ncbi.nlm.nih.gov]
In 1952 Anderson and Margolis3reviewed the literature and reported that there were approximately 30 cases of scleral disease, either similar or related in varying degrees to this condition. [acpjournals.org]
Watson Medicine British medical journal 1978 Although scleral disease is uncommon, it is associated with connective-tissue disorders and one series showed that 27% of patients who develop necrotising scleritis are dead from systemic complications within [semanticscholar.org]
Ophthalmology 1984 ; 91 : 1253 – 63. 5 Destructive corneal and scleral disease associated with rheumatoid arthritis. Medical and surgical management. Cornea 1995 ; 14 : 408 – 17. © The Author(s) 2018. [academic.oup.com]
- Eye Pain
[…] and discharge (Medical Encyclopedia) Eye pain (Medical Encyclopedia) Eye redness (Medical Encyclopedia) Fluorescein angiography (Medical Encyclopedia) Fluorescein eye stain (Medical Encyclopedia) Heterochromia (Medical Encyclopedia) Ophthalmoscopy (Medical [icdlist.com]
Severe eye pain that responds poorly to painkillers is the main symptom of scleritis. Eye movements are likely to make the pain worse. The pain may spread throughout the entire face, particularly on the side of the affected eye. [healthline.com]
Practice Essentials Scleral inflammation (scleritis) may occur in one or both eyes. Pain is a hallmark symptom. [emedicine.medscape.com]
Musculoskeletal
- Arthritis
Br J Ophthalmol 1976 ; 60 : 163 – 91. 2 Rare extra-articular manifestation of rheumatoid arthritis: scleromalacia perforans. Kaohsiung J Med Sci 2005 ; 21 : 233 – 5. 3 Extra-articular manifestations and complications of rheumatoid arthritis. [academic.oup.com]
It is rare in the sense that we usually see scleromalacia perforans with fixed deformities of rheumatoid arthritis in the hands or progressed systemic complications but not as a starting landmark of disease. [springermedizin.de]
1 Scleromalacia perforans in rheumatoid arthritis. ( 30597078 ) 2018 2 Scleromalacia perforans: a case report. ( 29866188 ) Ghauri MI...Bashir ZTA 2018 3 Scleromalacia Perforans from Long-Standing Bulbar Conjunctival Rhinosporidiosis. ( 27342330 ) Bothra [malacards.org]
Skin
- Ulcer
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]
FIGURE 2: (A) Conjunctiva surrounding scleral ulceration, resected at the time of dura-mater grafting, revealing severe chronic inflammation (original magnification ? 176). [healio.com]
Gastroenterology 1981 Jul;81(1):153-5 Ulcerative colitis is associated with many ocular complications. The only systemic disease currently recognized to be complicated by scleromalacia perforans is rheumatoid arthritis. [pubfacts.com]
She also complained of dry mouth, oral ulcers, and there was a history of stillbirth in eighth month of gestational amenorrhea 1 year back. [ncbi.nlm.nih.gov]
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
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]
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]
Han et al. concluded that the combined surgery of may be an effective and safe procedure for the treatment of scleromalacia after periocular surgeries. Citation : Han et al. [ologen.com]
Commercially prepared cadaveric dura mater can be successfully used as a tectonic graft for the treatment of scleral thinning. [ucdavis.pure.elsevier.com]
Prognosis
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 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]
Prognosis Prognosis varies depending on the disease classification. It may range from a self-limited episode of inflammation to a severe necrotizing process with vision-threatening complication. [emedicine.medscape.com]
Prognosis and Outcomes Scleromalacia Perforans has a good outcome provided the condition is diagnosed at an early stage and treatment started before any complication arises. [webeyeclinic.com]
Paralimbal scleromalacia perforans is reported to have a good prognosis without treatment.! In October 1983 a 33-year-old woman had a one-year history of foreign body sensation and a ten-day history of decreased vision in the right eye. [kundoc.com]
Etiology
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]
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/pathogenesis. Infectious scleritis (bacteria, viruses, ... Torsten Schlote, Jens Rohrbach, 2011 3 A Textbook of Ophthalmology Eventually it shows a picture of scleromalacia perforans. [educalingo.com]
PDF Permissions Buy CONSULTATION SECTION CORNEA Unilateral vortex keratopathy of unknown etiology Tauber, Jenna; Kang, Joann J.; Mifflin, Mark D.; More Journal of Cataract & Refractive Surgery. 48(10):1219, October 2022. [journals.lww.com]
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]
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]
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]
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]
Treating underlying autoimmune conditions that might cause scleritis is also important in preventing future problems with the sclera. [healthline.com]
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]
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]
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]