To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis.
Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis.
Fifty-five patients (56 eyes) with confirmed infectious scleritis were included. The median time from inciting event to scleritis symptoms was 1.9 months. Eyes with a history of pterygium surgery had a longer time from surgery to development of scleritis (median 49 months, range 0–183) compared to those with a history of glaucoma, cataract, and retina surgery (median 1.0–1.6 months; P = 0.001). Fungal, nocardial, and mycobacterial infections (median 17–45 days) had a longer interval between symptoms and diagnosis than eyes with non–acid-fast gram-positive and gram-negative bacteria (median 7 days; P = 0.04). Patients were followed for a median of 11.1 months (0.5–47 months). Approximately 50% of eyes lost functional vision (worse than 20/200). Presenting VA of worse than 20/200 and concomitant keratitis or endophthalmitis were associated with poorer VA outcomes.
Infectious scleritis can occur days to years after ocular surgery, with infection occurring after a longer interval in eyes with a history of pterygium surgery. Approximately 50% of eyes lost functional VA after infection with poor presenting VA being the strongest predictor for subsequent severe vision loss.
*Ophthalmology Department, Bascom Palmer Eye Institute, University of Miami, Miami, FL
†Ophthalmology Department, Miami Veterans Administration Medical Center, Miami, FL.
Reprints: Anat Galor, Bascom Palmer Eye Institute, University of Miami, 900 NW 17th St, Miami, FL 33136, (e-mail: email@example.com).
Supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD grant W81XWH-09-1-0675) (institutional grants).
The authors have no conflicts of interest to disclose.
Received October 5, 2011
Accepted April 8, 2012