Infectious Sclerokeratitis

A 79-year-old male presented to BPEI with 4 days of decreased vision and pain in the right eye. Visual acuity was hand motion and exam revealed a large multifocal corneal infiltrate with associated corneal and scleral thinning. B scan demonstrated large choroidal and retinal detachments. Patient underwent corneal cultures, anterior chamber tap (though unable to extract fluid) and intracameral antibiotics and was started on medical therapy. Corneal cultures grew Pseudomonas aeruginosa. The patient was admitted for IV antibiotics and steroids, and underwent surgical debridement with placement of a corneal graft and amniotic membrane. Surgical cultures of an inferotemporal scleral nodule also grew Pseudomonas aeruginosa. Patient continued on aggressive medical therapy consisting of topical and oral antibiotics, and topical and oral steroids. One month after initial presentation, patient’s visual acuity remained unchanged due to corneal scarring and persistent retinal / choroidal detachments, though there were no signs of active infection. The patient’s course and the management of infectious scleritis are discussed in this presentation. 

Presentation Date: 11/07/2019

Issue Date: 08/01/2020