A Case of Enucleation due to Extensive necrotizing Scleritis after Pterygium Excision in a Rheumatoid Arthritis Patient

ABSTRACT

The scleritis is developed after taruma, infection or associated with systemic disease in 505 such as connective tissue disease, granulomatous disease & metabolic disease, in which the most common disease is rheumatoid arthritis[RA]. Scleromalacia perforans characterized by progressive thinning of the sclera in the absence of symtoms and with minimal inflammatory signs is a typical type of scleritis in rhematoid arthritis patient. And necrotizing scleritis is associated with long-standing and severe RA in 4-10%. However, there has been no effective method for preventing those diseases. In order to prevent recurrence of pterygium, anti-metabolic agent or radioactive material has been applied to excision site. However, in case of RA, excessive application of above method or aggressive excision of pterygeal mass is rather avoided to prevent postoperative necrotizing scleritis. In this study, we reported a case of enucleation with histology due to severe necrotizing scleritis with extensive exposure of choroid in a 67-year-old man having a past history of RA for 20 years and pterygium excision[OS] 15 years ago.