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2010 OMIG, Abstract 4

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Diagnosis, treatment and outcomes of patients with infectious scleritis
K. H. MD1, A. Galor MD1,2, C.L. Karp1, T.A. Albini1, V.L. Perez1,  J. Davis1, D. Miller1, R.K. Forster1
1Bascom Palmer Eye Institute, University of Miami, Miami, FL; 2Miami Veterans Administration Medical Center, Miami FL

Purpose:  To evaluate the inciting factors, diagnostic accuracy, causative organisms, and treatment outcomes of patients with infectious scleritis.
Methods: Design: Retrospective study.  Participants:  Patients with infectious scleritis seen at Bascom Palmer between 1988 and 2000. 
Results:  The authors present a series of 10 patients whom were diagnosed with infectious scleritis at Bascom Palmer Eye Institute.   The median age at presentation was 64 years.  An inciting factor could be identified in all patients and included prior ocular surgery in 9 eyes and a history of trauma in 1 eye.  The median time from identified inciting event to the occurrence of infectious scleritis was 1 month. All eyes were correctly identified as having infectious scleritis and appropriate anti-microbial treatment was started shortly after the diagnosis of scleritis. A bacterial cause was identified in 90% of patients.  All patients received medical treatment in the form of topical (60%), oral (40%), intravenous (50%), subconjuntival (50%) and intravitreal (10%) antimicrobials.  In addition, 9 patients required 1 or more acute surgical procedures to eradicate the infection with 1 patient requiring an enucleation.  The median time to resolution of infection was 34 days.
Conclusion: Infectious scleritis can occur days to years after ocular surgery.  While intensive medical and surgical treatment can eradicate the disease in most patients, the visual prognosis is guarded due to the development of multiple concomitant ocular complications.

Disclosure Code: N

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