Scleromalacia as a complication of herpes zoster ophthalmicus

Berry-Brincat, Antonella; Lany, H von; Evans, Natashia

doi:10.1038/sj.eye.6700336

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…4 It has been suggested that severe episodes of HZO, complicated by iridocyclitis and elevated IOP, are more likely to be associated with later development of scleromalacia. 3 We postulate that pseudophakia may increase the risk for spontaneous globe perforation in the presence of scleromalacia. This may be due to involvement of a surgically thinned scleral area or outward pressure from the IOL haptic.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus

Ahmed

Carrim

Diaper

et al. 2007

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 99%

“…3 Various mechanisms including direct viral invasion of the sclera and immune-complex-mediated vasculitis have been proposed for the scleral involvement in HZO. 4 It has been suggested that severe episodes of HZO, complicated by iridocyclitis and elevated IOP, are more likely to be associated with later development of scleromalacia.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus

Ahmed

Carrim

Diaper

et al. 2007

Journal of Cataract and Refractive Surgery

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“…The most common causes of corneal melt are herpes simplex virus keratitis 5 and retained lenticular material in the postsurgical setting. 6 Among all corneal insults, chronic inflammation at the limbus appears to be a common factor for postoperative corneal melting.…”

Section: Discussionmentioning

confidence: 99%

The CT Appearance of a Corneal Melt: Report of 2 Cases

Bluestone¹,

Ackert²,

Som³

2011

AJNR Am J Neuroradiol

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SUMMARY:When the cornea of the eye dissolves, most commonly secondary to infection or trauma, the ventral wall of the anterior chamber of the eye is no longer supported and thus bulges forward, enlarging the anterior chamber volume. This is referred to as a corneal melt, and it has a unique CT appearance that has not been previously described.A corneal melt is a complete breakdown of the corneal structure, which can be initiated by a variety of conditions most commonly related to infections, prior surgery, systemic or localized autoimmune diseases, or trauma. When a corneal melt occurs, it results in an enlarged anterior chamber of the eye and it has a unique CT morphology, which does not appear to have been previously described, to our knowledge. The purpose of this article is to report 2 cases of corneal melt: 1 related to herpes simplex infection and 1 related to trauma after cataract surgery and a corneal transplant. Case Reports Case 1The patient was a 51-year-old man with no significant medical history. His ocular history was significant for herpetic keratitis treated at an outside institution. The patient reportedly had a neurotrophic ulcer secondary to herpetic eye disease, which he said resolved 4 months earlier. Approximately 3 months before his present admission, he noted progressively worsening vision associated with ocular pain. At the time of presentation, he had no light perception in the right eye and was 20/40 in the left eye. He was noted to have a tension of 76 in the affected eye. The anterior segment of the eye was disorganized with opacification, and no corneal layers could be identified. There was no view to the posterior pole. On B-scan sonography, the retina was flat without any significant vitritis. The lens was noted to be thickened and slightly displaced anteriorly. A CT scan of the orbits showed a grossly enlarged anterior chamber in an otherwise unremarkable eye (Fig 1). Five days later, the patient had an enucleation of the right eye. Case 2The patient was a 90-year-old woman with a medical history significant for migraines and gait imbalance, and an ocular history significant for bilateral cataract extractions 20 years ago and corneal transplantation in the left eye 9 years ago, with a limbal relaxing incision performed 1 year later for a residual refractive error. On presentation to the emergency department for a fall, she had decreased vision in her left eye, and an examination revealed multiple facial lacerations. Her ophthalmic examination showed a flat anterior chamber with prolapsed uveal tissue. Her CT of the head and orbits showed no evidence of acute orbital fracture. However, there was an enlarged anterior chamber in her left eye (Fig 2). After appropriate antibiotic and tetanus vaccine prophylaxis, she was taken to the operating room where it was found that her corneal transplant wound had dehisced and the intraocular lens placed at the time of cataract surgery had extruded from the eye and was found in the inferior fornix. DiscussionThe corneal epithelium is important ...

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“…Irrespectively of the final diagnosis, autoimmune reaction is responsible for the vessels damage (type III hypersensitivity) [1,2,24]. That is why in cases with severe necrotizing scleritis immunosuppressive therapy, supplemented with steroids is suggested to interrupt destructive process [1,2,6,9,[12][13][14][15]17,18,24]. Cyclophosphamide is known as the most effective drug in patients with noninfectious necrotizing scleritis (oral dose 2-3 mg/kg/d).…”

Section: Therapymentioning

confidence: 99%

“…The condition was also described in other systemic vasculitic and collagen disorders (up to 66%): systemic lupus erythematosus, periarteritis nodosa, Wegener's granulomatosis, Behçet disease, limited scleroderma, Crohn's disease, graft-versus-host disease. SP was also observed in porphyria and herpes-zoster infection [2,[8][9][10][11][12][13][14][15] (Figure 1).…”

mentioning

confidence: 99%

Scleromalacia Perforans–What We Know and What We Can Do

Kopacz¹

2011

J Clin Exp Ophthalmol

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Scleromalacia as a complication of herpes zoster ophthalmicus

Cited by 8 publications

References 10 publications

Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus

Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus

The CT Appearance of a Corneal Melt: Report of 2 Cases

Scleromalacia Perforans–What We Know and What We Can Do

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